
Class 
Book. 



-T? 



SMITHSONIAN. DEPOSIT 



" 







THE 



MEDICAL COMPANION, 




OR 



FAMILY PHYSICIAN: 

TREATING OF THE 

DISEASES OF THE UNITED STATES, 

WITH THEIR SYMPTOMS, CAUSES, CURE, AND MEANS OF PREVENTION*. 

COMMON CASES IN SURGERY, AS FRACTURES, DISLOCATIONS, &c. 

THE MANAGEMENT AND 

DISEASES OF WOMEN AND CHILDREN. 

A DISPENSATORY FOR PREPARING FAMILY MEDICINES, 

AND A 

GLOSSARY EXPLAINING TECHNICAL TERMS. 

TO WHICH ARE ADDED, 

A BRIEF ANATOMY AND PHYSIOLOGY OF THE HUMAN BODY, 

SHOWING, ON RATIONAL PRINCIPLES, THE CAUSE AND CURE OF DISEASES : 

AN ESSAY ON HYGIEINE, 

OR THE ART OF PRESERVING HEALTH WITHOUT THE AID OF MEDICINE: 

AN AMERICAN MATERIA MEDICA, 

POINTING OUT THE VIRTUES AND DOSES OF OUR MEDICINAL PLANTS. 
ALSO, 

THE NURSE'S GUIDE. 
byTTmes^ewell, 

PHYSICIAN IN WASHINGTON, FORMERLY OF SAVANNAH. 

THE TENTH EDITION, 

REVISED, ENLARGED, AND VERY CONSIDERABLY IMPROVED ; 
EMBRACING A TREATISE ON 

HYDROPATHY, HOMOEOPATHY, AND THE CHRONOTHERMAL SYSTEM. 



PHILADELPHIA: 

PUBLISHED BY CRISSY St MARKLEY, 
FOR JACOB A. GEER. 

1846. 



^G 



-£ 






\* 



Entered, according to the act of Congress, in the year eighteen hundred and forty- 
eight, by E. KINGMAN, in the office of the Clerk of the District Court for the 

District of Columbia. 



STEREOTYPED BY F. LUCAS, JR. 



PRINTED BY SMITH & PETERS, 

Franklin Buildings, Sixth Street below Arch, Philadelphia. 



RECOMMENDATIONS 



In testimony of the merits of this work, the following commendations, by- 
some of the most distinguished medical characters of the United States, 
are inserted; together with the letters of their excellencies, Thomas Jeffer- 
son, and G. Hyde de Neuville — also, a review by Professor Mitchell, of 
New- York. 

Baltimore, Nov. 18, 1822. 
Dear Sir, 

I have been truly gratified in the perusal of the Sixth Edi- 
tion of your "Medical Companion, or Family Physician" 

The improvements made in this new impression of your work, com- 
pared with the former editions, are, indeed, extensive and important. 
Independent of your having enlarged considerably on diseases gene- 
rally, you have introduced additional matter, which greatly enhances 
its value. The introduction of the Nurse's Guide, as also the treatise 
you have given on the management of female complaints, will have the 
most happy effects, in correcting the gross errors daily committed by 
ignorant persons, and thereby save many, valuable lives. 

I do not hesitate to say, that this new edition of your Medical Com- 
panion, is decidedly the best popular treatise on medicine, that has 
ever been published ; and considering it, as I verily do, a safe and use- 
ful guide for heads of families, as well as for young practitioners of 
medicine, I take much pleasure in recommending it to the attention of 
our fellow citizens, both in town and country. 

I will only add, if your book meets with that encouragement, to 
which it is justly entitled, you will very soon be called upon, by the 
public, for another edition. 

I am, dear sir, with much respect, 

Your friend and servant, 

COLIN MACKENZIE, M.D 

Dr. James Ewell. 



IV RECOMMENDATIONS. m 

Baltimore, JVcra. 18th, 1822. 
Dear Sir, 

When the Medical Companion was first published, I con- 
sidered it greatly superior to every work of that character I had read. 
I have now read the Sixth Edition, and am much gratified in having it 
in my power to say, that in this Edition you have so enhanced the 
value of the work, as to claim my unqualified approbation. 

Doctor Rush, during my residence in his house, often spoke of his 
intention to publish a medical work for the use of families, adapted to 
the climate of the United States. 

As he reserved it for the last act of his labours, for the benefit of 
mankind, unhappily he did not live to accomplish his design. In the 
work now presented to the public, you have fulfilled the patriotic in- 
tentions of the great and good Rush, to the utmost extent, and I sin- 
cerely hope your reward may be, as it deserves, ample. 

I am, dear sir, very truly yours, 

ASHTON ALEXANDER, M.D. 
Dr. James Ewell. 



Philadelphia, August 13, 1816. 
Dear Sir, 

I have looked over, with some care, the copy of the Third 
Edition of the "Medical Companion," which you did me the favour to 
present to me. 

By the additions and revisions given to this new impression of the 
work, it is not only enlarged, but exceedingly improved. 

After stating so much, I need hardly repeat an opinion, which I 
publicly expressed on a former occasion, that I consider it, as indispu- 
tably, the most useful popular treatise on medicine with which I am 
acquainted. 

Compared with the European Books of the same nature, it has, es- 
pecially in relation to the treatment of the diseases of our own coun- 
try, a very decided superiority. 

I trust that the success of this literary enterprise may be equal to 
your very generous and benevolent disposition. 

With great respect, I am, dear sir, yours, &c. 

N. CHAPMAN, M.D. 

Professor of the Institutes and Practice of Medicine, and 

Clinical Practice, in the University of Pennsylvania. 



RECOMMENDATIONS. V 

Philadelphia, Aug. 13M, 1816. 
Dear Sir, 

I have derived much satisfaction from a perusal of a third 
edition of your "Medical Companion." 

The additions and improvements which it contains, as compared with 
the first two editions of the work, are extensive and important. 

To families in the country, remote, not only from medical aid, but 
from places where common medicinal articles are to be procured, your 
Materia Medica alone, disclosing to them the healing resources of their 
own farms and forests, will be of high value. Nor, provided they be 
true to their best interests, and avail themselves of the advantages 
placed at their disposal, will your rules and directions for the preserva- 
tion of health, be less useful to them. 

In addition to these two important branches, now introduced into 
the Medical Companion for the first time, it contains a large amount 
of new miscellaneous matter, which cannot fail to be interesting to the 
reader. 

On the whole, if I be not greatly mistaken in my estimation of the 
character of your work, it is well calculated to prove extensively use- 
ful, and to place you in the midst of the permanent benefactors of 
your country. 

That you may receive, in reputation and wealth, your full reward, is 
the sincere wish of, 

Dear sir, your very humble 

And obedient servant, 

CH. CALDWELL, M.D. 

Now Professor of Materia Medica and Physiology 
in the Transylvania University. 

Dr. James Ewell. 



Philadelphia, December 31, 1807. 
Dear Sir, 

I have read your book entitled " The Medical Companion," 
with pleasure, and think it worthy the attention of the citizens of the 
United States. 

W. SHIPPEN, M.D. 

Professor of Anatomy. 

Dr. James Ewell. 



VI RECOMMENDATIONS. 

Philadelphia, December 31, 1807. 
Dear Sir 

I have carefully perused your work, " The Medical Com- 
panion" and take much pleasure in expressing my entire approbation 
of the plan, and of the utility with which you have conducted your 
inquiries. Your book cannot fail to be a very acceptable present to 
the public in general, and especially to our own countrymen. I really 
am of opinion, that you are entitled to much praise for the pains which 
you have taken in furnishing us with a work, the want of which has 
long been experienced among us. 

Your friend, &c. 

B. S. BARTON, M.D. 

Professor of Materia Medica, 
Natural History and Botany. 

Dr. James Ewell. 



December 28, 1807. 
I have read " The Medical Companion" by Dr. James Ewell, with 
satisfaction. It is a book containing a variety of matter in a small 
compass. The practice which he recommends in diseases, is modern 
and judicious, and the work cannot fail of being useful in all families 
in the United States. 

JAMES WOODHOUSE, M.D. 

Professor of Chemistry in the University 

of Pennsylvania. 

* Dr. James Ewell. 



Dear Sir, 

I have looked over your " Medical Companion" with plea- 
sure. The arrangement of the various parts is judicious, the language 
plain and perspicuous, and the sentiments happily condensed ; the 
modes of treatment grow out of the most improved state of our sci- 
ence, and may serve as a safe and useful guide to every family cut off 
from the services of able physicians. 

Accept the homage of my regard, 

JOHN B. DAVIDGE, M.D. 

Professor of Anatomy, Surgery, &c. 

in the College of Medicine in Maryland. 

Baltimore, Feb. 19, 1808. 
Dr. James Ewell. 



RECOMMENDATIONS. Vll 

Dear Sir, 

We have perused your u Medical Companion'' with much 
satisfaction, and strongly recommend it to the attention of those fami- 
lies who cannot with convenience procure medical aid. We think it 
the best publication we have ever read on the domestic treatment of 
diseases, more especially as it regards those of our climate. 
We are, very respectfully, sir, 

Your most obedient servants, 

BROWN & MACKENZIE. 
Baltimore, March 4, 1808. 
Dr. James Ewell. 



Sir, 

T have read your book on Domestic Medicine with pleasure. The 
practice recommended in it is judicious, and, being from the pen of a 
native physician, has great advantage over the publications of Euro- 
pean authors.. 

JOHN SHAW, M.D. 

Professor of Chemistry 
in the College of Medicine in Maryland. 

Dr. James Ewell. 



Charleston, May 7, 1808. 
Dear Sir, 

Your "Medical Companion" contains much useful know- 
ledge in a small compass, and is particularly adapted to these States, 
Families remote from medical aid, will find their account in possessing 
a book which describes diseases so plainly, and prescribes for them so 
judiciously, as bid fair to save valuable lives, which otherwise might be 
lost. 

Your most obedient servant, 

DAVID RAMSAY, M.D. 
Dr. James Ewell. 



VU1 RECOMMENDATIONS. 

Charleston, S. C. May 12, 1808. 
Dear Sir, 

The perusal of your "Medical Companion" has given me 
the greatest satisfaction. Such a publication has been much wanted, 
and I think the plan and execution of your work must answer the most 
valuable purposes. 

Yours, very truly, 

ALEXANDER BARRON, M.D. 
Dr. James Ewell. 



Charleston, May 14, 1808. 
Dear Sir, + 

I have, with great pleasure, perused your "Family Physi- 
cian." I find it to be a well digested compend of the most modern 
and approved modes of treating diseases, especially those to which our 
country is most exposed. — You have subjoined a dispensatory, judi- 
ciously calculated to obviate those errors which too frequently ensue 
from the exhibition of medicine, where the aid of the practitioner can- 
not be obtained. 

Yours, &c. 

PHILIP G. PRIOLEAU. 
Dr. James Ewell. 



Washington, March 1, 1808. 
Sir: 

I return you my thanks for the copy of " The Medical Compa- 
nion," you have been so kind as to send me, and must particularly ex- 
press my sense of the favourable sentiments expressed towards me in 
the beginning of the work ; especially, too, where it recalls to my re- 
collection the memory of your respectable father, who was the friend 
and companion of my youth, and for whom I retained through life an 
affectionate attachment. The plan of your work is certainly excellent, 
and its execution, as far as I am a judge, worthy of the plan. It brings 
within a moderate compass whatever is useful, levels it to ordinary 
comprehension, and, as a manual, will be a valuable acquisition to 
every family. 

I pray you accept my salutations and assurances of esteem and- 
respect. 

TH. JEFFERSON. 

Dr. Ewell. 



RECOMMENDATIONS. 



IX 



Sir, 



Washington, July 3, 1819. 



I had the honour to thank you viva voce, after having received 
your book : I owe you new thanks after perusing it. 

Such a work would be useful, very useful, in every country, but it 
may be said it is necessary in the United States, and you have acquired 
true titles to the gratitude of your fellow-citizens, and specially that of 
families who happen to be distant from medical aid, by pointing out to 
them the surest and, at the same time, the simplest rules to be followed 
in case of sickness. 

I, above all, offer up my prayers, that your wise hints to ladies may 
not be laid aside, and that mothers of families may impress them into 
their minds. 

Consumption, that inexorable enemy of youth and beauty, is indeed, 

in most instances, but the mournful result of an imprudent fashion, and 

it cannot be too often repeated to young ladies who do not fear to show 

themselves at assemblies in winter, in light dresses, that which a great 

physician answered to one of his friends who told him, I am well, I 

have only got a cold : " Colds," said he, " take away more people than 

the plague P 

G. HYDE DE NEUVILLE. 
Dr. James Ewell. 



The following Review is from that celebrated Work, the New York 
Medical Repository. 

Manuals of health, or popular publications on medicine, have be- 
come so frequent as to have excited the censure of some grave and 
oracular members of the profession. They consider their publishing 
brethren as unnecessarily divulging the arcana of the art, as deprecia- 
ting its credit and estimation, and as teaching the common mass of 
readers to know as much as themselves. This communicative dispo- 
sition they conceive to be carried to a very faulty extreme. For when 
the secrets of the healing faculty are promulgated by its members with 
such consummate knowledge and success, what is left for distinguish- 
ing the regularly initiated from those who are without the pale? The 
propagation of the Esculapian mysteries is viewed to be faulty on an- 
other account; in as much as in diminishing the importance, it lessens 
the profits of the practisers, and thus, for the gratification and emolu- 
ment of one tell-tale author, the whole fraternity is disparaged. 
2 



X RECOMMENDATIONS. 

Let us, however, do justice to those sons of physic who are thus ac- 
cused of faithlessness, in uttering abroad those matters which ought to 
be viewed as under the restriction of closed doors. Contrast their 
conduct with that of another class of medical personages, who forever 
deal in nostrums, and are incessantly boasting of their wonder-work- 
ing powers; who assure the credulous world they can cure every pos- 
sible disease of mind and body ; but with a cunning equal to their 
effrontery, permit no mortal to become acquainted with their remedies. 
Compare the conduct of him who withholds nothing from his fellow- 
citizens, with that of him who keeps every thing to himself. There 
can scarcely be a stronger exhibition of generous communication on 
the one part, and of selfish concealment on the other. Whatever may 
be pleaded in behalf of the persons who refuse to make a magnani- 
mous publication for the good of mankind, of such valuable means of 
cure as they may possess, or who secure the profits of them under sta- 
tute of patents, there certainly is a character of greater disinterested- 
ness and philanthropy, and a temper of a brighter mould and finish in 
him, who, without fee or price, offers to his fellow creatures all he 
knows that will be beneficial to them. 

We know it has been said, that a smattering in the knowledge of 
the animal economy, and of diseases, multiplies the number of patients, 
and encourages the practice of physic. Books on such subjects, ad- 
dressed to the people at large, are peculiarly calculated to alarm their 
fears whenever they are unwell, and, therefore, impel them to seek as- 
sistance from those on whose skill they rely. It has been surmised 
too, that the disciples of Buchan, Willich, and their coadjutors, have 
often been led, from superficial and conceited knowledge, to become 
prescribers to others, and have, by their blunders, rendered the attend- 
ance of the regular physician more needful than ever. Hence it has 
been argued, that publications of this kind fail to promote the plausi- 
ble object of their composition, and in reality, produce a mischievous, 
and not a beneficial effect. It has even been urged against them, that 
they are of no service to any person but the writer, who may diffuse 
his fame and increase his wealth in proportion to the circulation of his 
book and the consequent disturbance it works in society. 

Whatever may be the merits of this controversy among those who 
are toiling night and day in the service of the infirm and disabled, or 
in the compilation of volumes, for our own parts, as reviewers, we 
feel favourable to the general distribution of knowledge. We are not 
attached to monopolies of any kind, and less than any, to that which 
confines to a particular order, the information which will teach man 



RECOMMENDATIONS. XI 

how to prevent sickness and- pain, and to remove these ills when they 
invade. He who publishes wholesome precepts and directions, cannot 
be denied the merit of good intention ; and it would be hard to refuse 
him the additional credit of having done substantial good to those who 
have followed his advice. Having indulged these prefatory reflections, 
we advance to the consideration of the work before us. 

The author has prefixed to it a dedication to the President of the 
United States, a preface explanatory of his design, and a number of 
recommendatory epistles from his friends. Then follows a chapter of 
preliminary observations, of which we were inclined to offer an extract 
for the gratification of our readers; but our limits forbade. 

The body of the work is devoted to the consideration of the princi- 
pal diseases which assail the human frame at different times of life. 
Thev begin with fevers, and end with rickets; without, however, ob- 
serving any strict method or nosological arrangement. Each section 
stands by itself, and has little or no connexion with the preceding or 
subsequent matter. — But a table of contents and index are two good 
keys to the subjects discussed. 

The diseases are severally considered in short and generally appro- 
priate terms. After a definition, the observations are mostly comprised 
under the head of symptoms, causes, treatment, regimen; to which, in 
some instances, are added paragraphs on prevention. And it is but 
justice to observe, that the author has manifested a careful and discri- 
minating mind in condensing so much valuable instruction into such a 
moderate compass. The sententious and, and at the same time intel- 
ligible manner of conveying his directions, is at once calculated to 
give the reader a clear idea of his meaning, and favourable opinion of 
his understanding. 

Besides the observations that are strictly medical, the work contains 
a variety of directions upon surgical subjects. 

To render his compilation more generally useful and acceptable, the 
author has annexed to it a dispensatory. This consists of two parts: 
the first comprehends a table of medicines for family use, with their 
doses and qualities annexed ; and the second contains a collection of 
recipes for the principal part of the compound medicines recom- 
mended in the course of the work. And this part of the publication 
is executed in a manner that justifies the opinion we hinted before, of 
Dr. Ewell's sagacity and skill. 



TO HIS EXCELLENCY 



THOMAS JEFFERSON, 



PRESIDENT OF THE UNITED STATES 



I beg leave to present this Book to Mr. Jefferson, 
not because he is President of 1807, but because he 
was the patriot of 1776; and still more, because, 
through the whole of a long and glorious life, he has 
been the philosopher and friend of his country : with 
all the ingenuity of the former, exposing the misrep- 
resentations of illiberal foreigners ; and, with all the 
ardour of the latter, fanning the fire of American 
science, and watering the roots of that sacred olive 
which sheds her peaceful blessings over our land. 

To whom, then, with equal propriety, could I 
dedicate a book, designed, at least, to promote health 
and longevity ? And to whom am I so bound by the 
tenderest ties of affection and gratitude, as to Mr. 



XIV DEDICATION. 



Jefferson ? The early classmate and constant friend 
of my deceased father, and instrumentally the author 
of my acquaintance with the first characters in the 
State of Georgia ; among whom, with peculiar plea- 
sure, I would mention the honourable names of Mil- 
ledge, Troup, Bullock, and Flournoy. 

That you may long direct the councils of a united 
and wise people, steadily pursuing health, peace, 
and competence, the main pillars of individual and 
national happiness, is the fervent prayer of your 
Excellency's 

Much obliged, and 

Very grateful servant, 

JAMES EWELL. 



THE 



MEDICAL COMPANION, 



AND ITS AUTHOR, 



JAMES EWELL, M.D 



In presenting to the public the Tenth Edition of the Medical 
Companion, and in claiming for it a continuance of that public 
favor which has ever been freely bestowed upon it, it is proper to 
give some account of the life of the author, and the history of the 
work. 

Dr. JAMES EWELL was born at his paternal mansion, Belle 
Air, in the county of Prince William, Va., the 16th day of February, 
A. D. 1773. His father, Colonel Jesse Ewell, was of Welch 
descent, and a man of distinction and liberal fortune. Colonel 
Jesse Ewell was educated at William and Mary College, at Wil- 
liamsburg, where he was the classmate of Thomas Jefferson, with 
whom he formed a lasting friendship. He married soon after he 
left college, and preferring the tranquil and domestic life of a plan- 
ter, to a professional or political career which his talents opened to 
him, he settled at Belle Air, which he left only at the call of his 
country, at the head of a regiment of Virginia militia, of which he 
was appointed Colonel, during the war of the Revolution. His 
wife bore to him nineteen children, of whom eleven were reared 
to maturity. Of this numerous and happy family, James was the 
third son, and every care was taken of his education. Every facility 
that paternal intelligence, and the literary institutions of the county 
could afford, was enjoyed by him. 



XVI MEMOIR OF DOCT. JAMES EWELL. 

Having completed his literary studies, he commenced the study 
of medicine, under the direction of his uncle, Dr. James Craik, 
of Alexandria, the family physician of General Washington. Sub- 
sequently, with a view to obtain greater facilities, he put himself 
under the instruction of Dr. Stevenson, an eminent physician, of 
Baltimore, and was by him introduced into a practical knowledge 
of the profession, visiting his patients in his company. From Balti- 
more his ardent pursuit of medical knowledge led him to Philadel- 
phia, where he attended the Lectures of the Medical Department 
of the University. Dr. Rush was then at the head of the Medical 
School as the Professor of the Theory and Practice of Medicine, 
and was succeeded by the celebrated Dr. Benjamin S. Barton, 
between whom and Doctor Ewell a friendship was formed that was 
severed only by death. Dr. Barton never ceased to take an interest 
in the professional career of his friend, and expressed strong appro- 
bation of the medical work, which Dr. Ewell subsequently pro- 
duced. The last time that they met was on board of a steam-boat 
between Baltimore and Philadelphia, in 1815, when Dr. Barton 
had just returned from Europe, in miserable health. Although there 
were a number of distinguished persons on board who felt a deep 
interest in Dr. Barton, he would receive no one in his state room 
but Dr. Ewell. 

Leaving Philadelphia, he returned to Virginia to fix upon a set- 
tlement, and, of course, to marry. A regard for the character and 
attainments of Doctor Andrew Robertson, of Lancaster county, Vir- 
ginia, had led him to visit his house, where he became acquainted 
with the Doctor's eldest daughter, Margaret Mcintosh Robertson, 
whom he married on the 2nd day of December, 1794. 

Doctor Robertson was a surgeon and physiciau of great eminence. 
He was born at Inverness, Scotland, in 1716, and graduated at 
Edinburg. Through the influence of his cousin, Dr. Thomas 
Munro, he was appointed a surgeon in the British army, and served 
three years in Flanders, in what was called the Pragmatic war, and 
was present at the disastrous action of Fontenoy, in 1 745. 

Ten years afterwards his regiment was sent to America, under 
General Braddock, and he accompanied it, in the spring of 1755, 
when the combined forces of royal and provincial troops marched 
against Fort Du Quesne. From the fearful slaughter of Braddock's 
defeat he escaped, with a small squad of twenty men, and living on 



MEMOIR OF DOCT. JAMES EWELL. xvii 

acorns alone made his way to Dunbar's camp, to which the rem- 
nants of the army, under Colonel Washington, had retreated. 

Forming a favorable opinion of the prospects of America, Doctor 
Robertson, soon after his return home, resigned his commission, 
and determined to emigrate, with his family, a wife and son, to 
Virginia, and devote himself to the practice of medicine and surgery. 
He landed at Indian Banks, Richmond county, Virginia, where he 
was hospitably received and entertained by a wealthy Scotch mer- 
chant, Mr. Glasscock. He was requested to prescribe for Mr. Glass- 
cock's daughter, an infant in the cradle, who was sick of the mea- 
sles, and this, his first patient, became his fourth wife, in the year 
1771. Dr. Robertson settled in Lancaster county, and his sterling 
merit, and great skill, soon gave him the control of the practice of 
the northern neck of Virginia, then one of the richest and most 
prosperous portions of the State. He acquired wealth as well as 
fame, and continued in active practice till the day of his death, 
which occurred March 1st, 1795, at the age of seventy-seven. This 
distinguished physician bestowed his friendship and his daughter 
upon Dr. Ewell, for whose professional promise he entertained a 
high regard. 

Dr. Ewell purchased a farm in Lancaster county, and immedi- 
ately commenced a successful practice. But the country practice 
and the care of a plantation were soon exchanged hy him for a re- 
sidence in the town of Dumfries, in his native country. A still 
wider circle of city practice was desired by him, and he was strenu- 
ously advised by his friends to go to a Southern city. In 1801, he 
visited his father's friend, Mr. Jefferson, who had just become Presi- 
dent, at Washington, and stated to him his designs. " Will you," 
said Mr. Jefferson, "come and dine with me to-day ; some of my 
Georgia friends ?)]11 be here, and, perhaps, you may finally settle 
in Savannah." It was at this dinner party that Dr. Ewell met 
several distinguished Georgians, with whom he formed a pleasing 
and lasting acquaintance. His determination was soon formed, the 
city of Savannah would, henceforth, be his home. Mr. Jefferson 
was, at this time, receiving from Dr. Waterhouse, and others, the 
vaccine matter in quills, and he presented one of them to Dr. Ewell, 
and by this timely present, Dr. Ewell was enabled to be the first 
person who introduced vaccination into Savannah. Mr. Jefferson 
also gave the Doctor some very strong letters of introduction, and 
3 



XV111 MEMOIR OF DOCT. JAMES EWELL. 

recommendation, to a number of gentlemen in Georgia, securing 
for him, in that State, a hearty welcome, which his merit soon ri- 
pened into enduring esteem. During a residence of six or seven 
years in Savannah, he practised his profession with distinguished 
success. His fondness for social intercourse, in its best forms, found 
ample means of gratification, in the polished and intelligent circles 
of that opulent city. It was during professional visits to the neigh- 
boring plantations, that his attention became fixed upon the neces- 
sity of affording, through the means of a popular work on medicine, 
necessary information as a guide for nurses, and heads of families, 
in the absence of professional aid. A number of planters, indeed, 
who had experienced the benefit, of his medical skill, urged him to 
furnish them some directions for their guide in case of sickness, in 
their large families of whites and blacks, in the form of a medical 
work. Soon after this, his brother-in-law, the distinguished and 
popular clergyman, the Reverend Mason L. Weems, being on a 
visit to him in Savannah, strongly recommended to him to prepare 
a work of this sort, and pointed to it as a source of great emolu- 
ment, while, at the same time, it would not interfere with his pro- 
fessional practice. Motives of philanthropy were, however, more 
influential than any other in inducing Dr. Ewell to undertake 
the task, for there was nothing mercenary in his character. He 
accordingly prepared the first edition of his work, and circumstances 
rendered it absolutely necessary for him to go to Philadelphia to 
have it brought out in a proper manner. It so happened that one 
of his earliest and most valued Georgia friends, Col. George M. 
Troup, had just returned from Congress, of which he was a promi- 
nent member, and he described Washington City as a place of ra- 
pidly growing importance, and affording excellent society, and a 
wade field for the exertion of medical science. Dr. Ewell having 
published his first edition of the Medical Companion, and finding 
that there was a large and increasing demand for it, was induced to 
remove to, and settle in Washington, where he could combine his 
practice, with a due degree of attention, to the improvement and 
publication of successive editions of his work. His departure from 
Savannah was deeply regretted by a large circle of attached friends 
and patients. 

In 1S09, Dr. Ewell became a resident of Washington, and he 
published a number of editions of his work, accompanied by his 



MEMOIR OF DOCT. JAMES EWELL. XIX 

medicine chests, which were put up under his own direction for the 
convenience of families, and were eagerly sought for, in eveiy part 
of the country, especially at the South and West. 

A number of editions of the work were published in Philadelphia ; 
one in particular, of great beauty of mechanical execution, by Abra- 
ham Small. The work was dedicated by him to Thomas Jefferson, 
not as the President, but as a patriot and philanthropist. The reader 
will find among the recommendatory notices of the work, a letter 
from Mr. Jefferson to Dr. Ewell, wherein he says that the work will 
be " a valuable possession in every family." He also speaks of 
Col. Ewell, the Doctor's "respectable father," who, he adds, was 
the friend and companion of my youth, and for whom I entertained 
through life, an affectionate attachment. In 1812, Dr. Ewell was 
strongly recommended by all the leading men in Congress from 
the South, and by the most eminent medical men in the country, 
for the office of Surgeon General of the army. Mr. Madison was de- 
sirous of appointing him, but the office had been promised by General 
Armstrong to another person. 
A 2 The ,, 6>Bfe edition contained an account of the capture of Wash- 
ington, under the head of Camp Fever, the Doctor having had 
occasion to witness the ravages of that disease. Of this episode in 
his work, the best opinion is given by Dr. Cutbush, then Surgeon 
of the Marine Hospital at Washington, who says, in a letter on the 
subject to his friend Dr. Ewell, that it was the most interesting, and 
the most faithful account of the event, with all its attendent horrors 
of destruction and pestilence, that had ever been, or could be given, 
but he did not consider a medical work the exact place for it. It 
was omitted in subsequent editions ; but it was a most vivid picture 
of stirring and exciting scenes, into which the Doctor had been 
called as a citizen or as a physician. His influence was exerted 
successfully with General Ross and Admiral Cockburn, in behalf 
of the preservation of private property, which had been doomed to 
destruction, on the ground that it had been used for military or 
public purposes; and he was continually active, in affording medi- 
cal aid and provisions to our starving and pestilence striken militia, 
and to the wounded of both armies. Dr. EwelPs house fronted the 
Capitol on the east, and was on the south corner of the block. 
The enemy entered the city on the evening of the 24th of August, 
1814, their troops dropping in numbers by the road side, from ex- 



XX MEMOIR OF DOCT. JAMES EWELL. 

haustion and heat. A company of sappers and miners, after setting 
fire to the Capitol, came up to Dr. Ewell's house to destroy it. He 
claimed it as private property, and also Colonel Caldwell's house, 
which had been consigned to destruction, from the circumstance 
of the contents of a baggage wagon having been emptied before the 
door, in the hurry and confusion of retreat. After some delay the 
order was countermanded, and the British General officers took pos- 
session of Dr. Ewell's house as their head-quarters, from its com- 
manding position. A terrific storm spent its fury on the devoted 
city about mid-day on the 25th, and when it had subsided, the sap- 
pers and miners were sent down to the arsenal to destroy it. Doc- 
tor Ewell was then in conversation with General Ross and Admiral 
Cockburn, having been requested by the neighbors to ask their in- 
tentions as to private property, when an explosion was heard that 
made the earth quake, and the strongest nerves tremble. Soon 
after, an officer rushed in, reporting that the Americans had sunk 
an immense quantity of powder in an old well at the arsenal, and 
a broken match thrown in by a careless artillerist, had produced the 
explosion, which had killed a number of officers and men. An or- 
der was issued for the wounded to be conveyed to a large unoccu- 
pied house in the immediate neighborhood ; and General Ross 
turned to Dr. Ewell and said : " Doctor, we must leave our wounded 
with you." The British left Washington during the night of the 
25th, after kindling, with incendiary torch, a private dwelling that 
occupied a bold site on the brow of the Hill, and making therefrom, 
a long line of bonfires, with a view to conceal their retreat from our 
troops, who were on the other side of the river. 

Doctor Ewell took charge of the British wounded, and furnished 
them with provisions, from motives of humanity, without the least 
compensation, until the Government made other provision for them. 
The Doctor's hair becoming somewhat silvery at this time, he was 
accustomed to say that the " capture of Washington had turned his 
hair gray." 

Dr. Ewell published the sixth edition of the Medical Companion 
in Baltimore, in 1822. 

In 1826, he published an improved edition, the seventh, on his 
own account, in Washington. This edition, like all that had pre- 
ceded it, met with great favor, and a rapid sale. 

Having sustained repeated and heavy losses, from the unfaithful- 



MEMOIR OF DOCT. JAMES EWELL. XXI 

ness of agents employed in the distribution of his work, Doctor Ewell 
again turned his attention to the South, and determined to devote 
his yet unimpaired energies, to the practice of his profession in New- 
Orleans, and while there, to take more especial notice than ever, of 
the wants of the South and West in reference to a medical work 
for the use of families. 

He practised in New Orleans about two years with his usual suc- 
cess, and his society was courted by many old friends whom he 
found there, and new ones that he soon made. 

In the fall of 1832, while in the full career of prosperous practice, 
he was attacked with a nervous fever, from which he so far recov- 
ered as to be taken by his friend, Dr. Read, to his house at Coving- 
ton, on Lake Ponchartrain, where he met with unceasing kindness 
and attention. His friends were congratulating themselves on his 
recovery, when suddenly, without warning, he became, with many 
others at Covington, a victim to the malignant Cholera. 

He died in the full possession of his faculties, and expressing the 
most entire resignation to the Divine will, on the morning of the 
second of November, 1832, in the sixtieth year of his age. His 
widow survived him ten years, and died at the residence of her 
daughter, Mrs. Olivia P. Martindale, at Sandy Hill, New York, 
Aug. 26, 1842. They had four children, two of whom died in in- 
fancy. The other two were daughters, and still survive, — Mrs. 
Martindale, at Sandy Hill, and Mrs. Cordelia B. Kingman, now a 
resident of Washington City. As a skilful physician, Doctor Ewell 
had no superior among his cotemporaries. His success was the best 
proof of his mastery in the healing art. As a friend and social 
companion, he was cherished wherever known. He was ever dis- 
tinguished as a promoter of social harmony and innocent amuse- 
ment, and the tranquil and temperate enjoyment of life, and the 
bounties of Providence. His benevolence was unbounded ; and his 
hospitality and charity knew no limit, but his means. 

Though always industrious, he was never, in a mercantile sense, 
a business man. He was deficient in the management and care of 
his property and income. 

What Sidney Smith says of Sir James Mackintosh was true of 
Dr. Ewell. " He knew not the use of red tape, and would not 
learn to tie up his bills and papers; and was, therefore, unfit for the 
common business of life. Hence, in his career he was sometimes 



XX11 MEMOIR OF DOCT. JAMES EWELL 

an example of the ancient and melancholy struggle of genius with 
the difficulties of existence." 

With the most gifted and eminent men of the day in which he 
lived, Dr. Ewell was personally intimate, and his house and table 
were their constant resort. He received his friends with a hearti- 
ness of hospitality that " warms more than wine." To his many 
students he gave his instructions freely and zealously, and often 
without compensation. Among them have been some of the bright- 
est lights that have adorned the medical profession. 

In person, Dr. Ewell was of the medium height, his limbs were 
finely moulded, his hands and feet were remarkably small, and in 
the latter portion of his life he was somewhat inclined to corpulency. 
His complexion was florid, his eyes large, and of a deep blue color, 
and his countenance was animated, expressive and intellectual. In 
deportment he was mild, affable, and polite. In the sick room his 
presence gladdened patients and friends, and never failed to cheer 
the anxious and despondent. As it has been the lot of few indi- 
viduals to have been more eminently gifted with the means of being 
useful to mankind, so, perhaps, no one, in a greater degree, ever had 
the art of creating firm and durable friendships. 

The engraving accompanying this edition is copied from a portrait 
that was painted just before his departure from Washington for New 
Orleans, and is considered a faithful and striking resemblance. 

The eighth and ninth editions of the work was revised and great- 
ly improved by the nephew of Dr. Ewell, Mason L. Weems, M. D., 
formerly of Washington, now of Texas. These editions were pub- 
lished in Philadelphia, by Messrs. Carey, Lea and Blanchard, and 
the family of Dr. Ewell derived some benefit from them. This, the 
Tenth Edition, has been much enlarged and improved by the ad- 
dition of important matter, under the direction of two eminent phy- 
sicians ; and from the extensive sale which is anticipated for it, some 
emolument will result to the remaining portion of Dr. E well's family. 



PREFACE 



On the important subject of domestic medicine, many books have 
been written, which, though excellent in other respects, have great- 
ly failed of usefulness to Americans ; because they treat of diseases 
which, existing in very foreign climates and constitutions ', must 
widely differ from ours. The book now offered to the public, has, 
therefore, the great advantage of having been written by a native 
American, of long and successful practice in the southern states, and 
who, for years past, has turned much of his attention to the com- 
position of it. 

The professed object of this book is to treat in the most clear and 
concise manner, almost every disease to which the human body is 
subject, to give their common names and surest symptoms, to point 
out the causes whence they originate, and the most approved method 
of treatment — and, lastly, to prescribe the suitable regimen and 
means of prevention. 

A publication like this cannot but be exceedingly useful to all, 
but especially to those who live in the country, or who goto sea, 
where regular and timely assistance cannot always be obtained. 

Among the many and great services to be rendered by such a 
book, we may fairly state its tendency to prevent that dangerous 
officiousness of ignorant persons, and, that equally pernicious ne- 
glect of the patient, at the onset of the disease, whereby so many 
lives are lost. These, with many other evils resulting from the want 
of such a work, constituted the motives which first led the author 
to offer this publication to his countrymen. It is not for him to de- 
termine whether it be happily executed or not ; but, whatever may 
be the general opinion as to its merit, he has the high satisfaction to 
know, that it not only flows from the purest motives, but also con- 
tains a faithful relation of facts, collected principally from his own 
experience, and, in part, selected from authors of the greatest 
celebrity. 



XXIV PREFACE. 

He has not hesitated, occasionally, to use the language of his fa- 
vourite authors, where he found it sufficiently clear and familiar for 
his purpose ; and he hopes this acknowledgment will be received in 
place of frequent reference and quotation. 

The reader will find, in the latter part of the work, a table of 
such medicines most commonly called for in families, with an adap- 
tion of the doses to the age of the patient, together with directions 
to prepare and administer them. And, as it is impossible entirely 
to banish technical phrases when writing on medicine, the reader is 
presented with a Glossary, explaining the medical and scientific 
terms unavoidably employed in this work. 

The author, animated by the extraordinary success of the "Med- 
ical Companion," has greatly improved and enlarged it, by a 
synopsis of the anatomy and physiology of the human body; 
essays on air, food, exercise, sleep, evacuations, and passions ; and a 
Materia Medica. 

Thus improved, the Medical Companion not only treats of the 
art of preserving health, and curing disease, but also inculcates a 
familiar knowledge of the human system, in all its parts, and the 
laws that govern its economy It is obvious, that by due attention 
to the non-naturals, by which is to be understood the means of pre- 
serving health, we may go far to protect this fabric from injury or 
disease. To inculcate this truth more universally and sue cessfully , 
the disquisitions contained in this work, are enlivened with appro- 
priate illustrations, calculated to make impressions on the mind of 
the reader, as lasting as they are important. 

Not the least valuable portion of this work is the Materia 
Medica, pointing out those precious simples wherewith God has 
graciously stored our meadows, fields, and woods, for the healing 
of our diseases, and rendering us happily independent of foreign 
medicines, which, while they are sometimes hard to be obtained, 
are frequently adulterated, and always costly. 

To conclude — the author having added much new and important 
matter to this eighth edition, it will, unquestionably, be found much 
more valuable than any of the former ; because he has laboured to 
correct in this, all the errors and imperfections that have hitherto 
appeared, has enlarged upon the treatment of most diseases, and has 
introduced several others, particularly that scourge of the South and 
West, the malignant fever, sometimes denominated the Cold Plague, 



PREFACE. XXV 

which were not previously noticed, though highly important to be 
well known and understood. 

In the present state of the science of medicine, daily improving 
by experience, and adding rapidly to the number of valuable reme- 
dies, he felt it incumbent upon him to enlarge considerably on the 
treatment of the diseases generally, as well as to make other addi- 
tions, which a work of this nature required, in order to its increased 
usefulness. 

In a familiar style he has pointed out the modus operandi of the 
different remedies ; has given the prognostics of diseases ; has no- 
ticed more particularly the circumstance whence the disorders origi- 
nate, for the purpose of guarding against occurrences ; has distin- 
guished those cases which yield readily to the employment of simple 
means, from those which require the regular attendance of a medical 
practitioner ; and has detailed the means for checking or retarding 
the progress of such cases. 

On the management and diseases of women, he has endeavoured, 
with the aid of the most distinguished authors on this subject, to give 
such a description of the complaints to which they are liable, with 
instructions for their treatment, plain enough, to be understood by 
the attendants or the patients themselves ; and which he sincerely 
hopes will in a measure have the tendency to correct the errors and 
misconduct of unskilful midwives, and to prevent unnecessary in- 
terference in young practitioners. To all of which has been added 
a general sketch of the diseases of infancy and childhood. 

With a view of correcting the gross errors of nurses, whereby so 
many valuable lives have been lost, there is introduced the " Nurse's 
Guide," describing the preparations of such aliments as are most 
proper for the sick ; which, as a family assistant, will, unquestiona- 
bly, be a valuable acquisition. 

Desirous that nothing should be omitted, which would in the least 
add to the value of the work, he has greatly improved the Dispen- 
satory ; which is now arranged in a manner that will not in the 
least perplex the reader ; having endeavoured to render each formula 
or prescription, as concise and clear as possible, both as to the mode 
of preparing and the intention of employing it by short practical re- 
marks under each class or head. 

He has likewise given a detailed Index, so that in all cases of 
disease, the reader may be directed without trouble or embarrass- 



XXVI PREFACE. 

inent to the appropriate remedies. And, that the bulk of the volume 
might not be :■: : laige, he has expunged many of the illustrations 
under the head of Hygieine. being of little importance compared 
with the matter now introdi; : 

The author cannot but think a work of this nature- will be ex- 
ceedingly useful to the studen:. whose theoretical knowledge 
only prepared him to commence the arduous dudes of his profes- 
sion : for. it will not be denied, that the most experienced practit: : nei 
occasionally feels the want of a guide in his practice. I; is wor- 
thy to be noticed, when the first edition of the Medical Companion 
was presented to the public. Professoi Barton, with his usual liber- 
ality and philanthropy, enjoined npon his pupils to procure a copy 
of the work before they entered upon the duties of their profess 
observing, at the same time, that he himself had profited by it in 
practice, by refreshing his memory ;: what he had read in more 
voluminous works 

To every family, more especially those in remote situations, the 
possession of this book must, unquestionably, be of incalcub 
value : for, conducted by such a guide, it will not be presumptuous 
to say that any person of tolerable capacity, and reasonable atten- 
tion, may be enabled be practise with safety and advantage, in ohose 
cases of simple diseases most incident to our climate, 

H:~ :";,: the author has accomplished his wishes in these impor- 
tant respects, the madei is left to judge from the high :es:imouials 
prefixed to the work, from ~::„e of the most iistinguished ph] f& ::: ns 
in our country. 

He will only add. from the rime and attention he has devoted, in 
makiiir the improvements now introduced, he cannot but flatter 
himself, the u Medical Companion' 3 will not fail to be acceptable :: 
his fellow-citizens : and. under this pleasing impression, he submits 
it to their generous patronage. 

For the notes and additions herein containe: the I li :. :-. . gely 
indebted to the works of D:s. Mason. Good. Gregory. McL 

7 [ inghson, Stokes and Ehotson; me London Lancet, Bos- 
ton Journal. Braithwa::.e's Retrospect &c ice. 



PRELIMINARY OBSERVATIONS. 



Contemplating the numberless diseases to which man is liable, 
and which may cause him to drag out a protracted life of distress, 
or suddenly cut him off in the bloom of his existence, and amidst 
his usefulness, we must adore the Divine excellence which has given 
us in medicine the means of counteracting their dreadful effects. 

As might have been expected, the attention to an art, rising in 
importance over all others, has ever kept pace with the general pro- 
gress of intellectual improvement, commanding for it the respect and 
encouragement of every enlightened people. 

With the Greeks, especially, the wisest and most polished of all 
the ancient nations, medicine was held in the highest estimation. 
Its votaries were cherished and revered by them while living, and in 
some instances, carrying their enthusiasm so far as to deify them af- 
ter death. It is not, indeed, easy to conceive a more noble charac- 
ter, than a great and amiable practitioner of medicine, who has ex- 
panded his mind to the utmost extent by the brilliant attainments 
of science, and mellowed the dispositions of his heart by the habit- 
ual exercise of benevolence towards the afflicted objects of his care. 
How exemplary are physicians of this description ! Such was Hip- 
pocrates, the father of medicine. Such was the pious, the enlight- 
ened Sydenham. Such was the benevolent Jones, of Savannah. 
Such was the enlightened Rush : and such are many others who 
have emulated their virtues and rivalled their fame ; among whom, 
I have the high satisfaction to enumerate of my particular friends, 
the late Drs. Craik, of Alexandria, Weems. of Georgetown, Ste- 
venson, of Baltimore, and Dr. Chapman, of Philadelphia. 

But unhappily, all those who profess our art do not resemble those 
bright examples. Medicine, more than any other good thing, is 
subject to abuse and debasement, by the sordid and mischievous 
" tricks and devices" of empericism. Like noxious weeds impos- 
tors rise up at first, from the rank soil of their own effrontery ; but 
they owe much of their subsequent growth to the protection which 
they derive from the want of that information widely diffused, which 
would at once detect, and "laugh into scorn" their idle claims, and 
arraign to conviction their dangerous tendencies. They live but by 
tolerance. The slightest examination of their pretensions would 



28 PRELIMINARY OBSERVATIONS. 

drive the herd into their holes and hiding places, and consign their 
widely spread fame to utter oblivion. 

It is strange, that so little popular curiosity prevails with regard 
to medicine, particularly when the public mind is so actively alive 
to subjects certainly of less moment. Talk to the generality of 
mankind about property, and you would suppose they were all 
lawyers, they reason so sensibly on the various points of nieum et 
tuum : but touch them about that which is of more worth than all 
property, I mean health, and they are silent as mutes. Did not ex- 
perience evince the fact, we should think it impossible that in things 
of such high concern, men could be so preposterously deceived ! so 
careful of the dross, and yet so negligent of the gold. 

What can be more deeply interesting than the investigation of that 
beautiful organization which has, emphatically, been pronounced 
" God's master work ?" What more important than acquiring the 
knowledge of preserving this admirable mechanism ? And what 
more pleasant and useful than to investigate the medical plants of 
our extensive country, whereby we may remedy those painful ma- 
ladies which assail the human frame? 

Half the attention and the time devoted to the minor politics aris- 
ing out of our party dissensions, assisted by very little of that over- 
boiling zeal given to the acquisition of property, would, if appropri- 
ated to medical studies, enable any person of tolerable capacity 
to practise with safety and advantage in those cases of simple disease 
which are most common to our climate, and to determine between 
the "arrant quack" and the modest, well educated, and judicious 
physician. 

Assuredly, some care might be profitably directed to medicine. 
Why will not the intelligent citizens who are scattered throughout 
the country, dedicate a part of their " liberal leisure" to it? Of all 
the sciences it is the most inviting, and that which opens the largest 
treasures to its cultivators. No one can lend his mind to it without 
receiving "usurious interest." Medicine is the digest of human 
knowledge. It is the great reservoir into which every stream of 
science pours its tribute, which in return spreads its fertilizing water 
over eveiy field that brings forth its " ripe and abundant harvest." 

The want of a popular medical education, we have remarked, 
promotes the success of empirics. To what else can the amazing 
increase of these creatures be ascribed ? Would they dare to quit 
the shades of their native insignificance, if they thought they were 
to encounter the blaze of criticism, or to be inspected and scruti- 
nized by the torch of truth ? No : the terrors of such a process, were it 
practised, would exterminate the race, or leave to them only a " beg- 
garly account of empty boxes." 

We repeat, that empirics are nurtured and sustained exclusively 
by the prejudices of mankind in their favour, arising from their ina- 
bility to judge rightly of their merits. For, can it be presumed that 
any one acquainted with the subject, would repose the slightest con- 
fidence in the nostrums of the most stupid, illiterate, dishonest, and 



PRELIMINARY OBSERVATIONS. 29 

vagrant of society, who are confessedly destitute of even the ele- 
ments, the mere alphabet of medicine. 

Who can believe, that these nostrums, as generally asserted by 
their proprietors, are applicable equally to a variety of diseases, op- 
posite to each other as the poles, and that too, under every differ- 
ence of age, constitution, temperament, habit, season, and climate ? 

Is it to be credited, that skill can be possessed in a profession the 
most complex, without any preparatory devotion to it ? Reason and 
experience combine, to assert the impossibility. 

The powers of eloquence or poetry may be an inheritance ; but 
medicine is not intuitive. Whoever acquires it, that is, that tho- 
rough knowledge of it, which confers " surpassing skill" must 
undergo a slow, toilsome, and arduous probation. 

Its temple is raised on the summit of the loftiest eminence, and 
the path which leads to it winds in tedious tortuosity, narrow, intri- 
cate, and perplexed ; but strewed at its different stages, with flowers 
to tempt, and hung at its termination with fruits to reward. Few, 
very few, have ever reached it. The majority of those who set out 
on the enterprise become soon discouraged, and either linger by the 
way, or are lost in its mazes. 

The energies of genius, assisted by unwearied diligence, can only 
hope to surmount the difficulties and to gain the prize. 

But candour must still allow that the empiric strengthens, in some 
degree, his credit with the public, by sometimes performing great 
and imposing cures. Such instances, however, of occasional suc- 
cess, bring with them no solid claims to confidence. They are, 
indeed, calculated to excite distrust when properly viewed. Their 
cures, which are admitted to be few, are alone registered and pro- 
mulgated. Nothing is ever said of the failures or the deaths pro- 
duced. No regular and impartial account is kept, nor any striking 
adjustment of balances : but what must be the fatality of a practice 
conducted in a way so rash and indiscriminate, without the guide 
of either principle or experience? The nostrums employed are 
uniformly composed of ingredients of the greatest activity, princi- 
pally of the mineral poisons, as arsenic, corrosive sublimate, calo- 
mel, &c, and which can never be neutral in their operations. 
Whenever administered, they assume a side in the pending contest, 
and exert all their might either for the patient or the disease, till one 
or the other yields. 

The preceding is a faithful picture of empiricism — of its swag- 
gering pretentions, of its danger, and its uncertainties ; a plain and 
unvarnished tale, in which naught is extenuate or set down in 
malice. 

But with the too prevalent inclination for nostrums, we regret the 
strange aversion that exists, and which proceeds from the same ne- 
glect of medicine, to* some of the most efficacious remedies. Tartar 
is denounced as a certain destroyer of the stomach ; mercury, be- 
cause it lodges in the bones ; arsenic, as rancorously poisonous, <fcc 



30 PRELIMINARY OBSERVATIONS. 

Thus are those powerful and salutary agents, when in the 
hands of a judicious physician, stigmatized by the false views of 
vulgar prejudice. It has been wisely and truly declared by high 
authority, "that all medicines in large doses are poisons, and that 
poiso?is in small doses are the best medicines." This is no paradox. 
The efficacy of a remedy must be proportioned to its force, provided 
it be administered with discretion, and its operation properly restrained. 

On the contrary, the weakest medicine becomes poisonous when 
given in an undue quantity. 

In the use of medicines we should be careful to adapt them to the 
nature of the disease, and the condition of the patient's system at the 
time; for the salutary properties of a remedy are not positive, but 
entirely relative to the peculiar circumstances of the case. 

A remedy, therefore, may do harm, or prove beneficial, according 
to the degree of judgment exercised in its employment. This po- 
sition might easily be illustrated and enforced by a variety of exam- 
ples. We shall mention, however, only a few most pertinent. 

What then is more sanative in its effects than the Peruvian bark 
in the treatment of intermittent fever, or gangrene ; or more delete- 
rious if given in an excited system ? Where is there a readier 
cleanser of a foul stomach than emetics? yet in inflammations of 
that organ, nothing would prove so pernicious. The same remark 
applies to cathartics, "nature's scavengers of a gorged alimentary 
canal." 

With regard to our lancet : what could we do without it ? How 
quell those dreadful insurrections of acute disease which every where 
ravage our country? But indispensable as it is in such cases, yet 
there is, perhaps, no remedy, which is more mischievous when 
wrongly applied. 

Who has not experienced the soothing restorative operation of 
opium, that divine medicine, which has not with too much force 
been called, " magnum Dei donum" the great gift of God ; and 
who has not known its demoniacal influence when imprudently 
employed ? 

In this way we might proceed through every class of the Materia 
Medica, deriving proofs to fortify our statement, and to warn us of 
the danger of abusing remedies. Enough, however, has been said. 
We trust the admonition will not be neglected. 

To apply, as we have indicated, the various medicines of which 
we are possessed, is the secret of successful practice, and constitutes 
the wide difference between the discriminating physician and 
empiric. 

The practice of the one is governed by principles slowly and cau- 
tiously deduced from the contributions of long experience and di- 
versified observations ; that of the other is the result of daring ex- 
periment, sanctioned only by the chances and calculations of the 
lottery. In the revolutions of the wheel, and amidst a thousand 
blanks, a prize may come out ! Thus, an important cure by an 



PRELIMINARY OBSERVATIONS. 31 

empiric, like an enormous prize, seizes public attention, and is 
sounded abroad by the "clarion of fame," while the evidence of the 
murderous practice, like the blanks of the lottery, is hushed in si- 
lence or buried in forge tfulness. 

It may be proper to observe here, that, in using all active medi- 
cines, we should begin with the smallest doses, increasing them 
gradually, until the quantity suited to the strength of the constitution 
be discovered. For there are instances of constitutions on which 
one-fourth, and even one-tenth, of what would not affect others, will 
act powerfully. 

As the system speedily accommodates itself to the action of medi- 
cines, we should never continue one medicine loo long at a time. 
When we find it is losing its efficacy, it should be changed for some 
other of the same class, and after a short interval the patient may, if 
he choose, return to his first medicine. By thus varying the reme- 
dies, as the system becomes accustomed to their action, we shall be 
enabled to cure diseases which, otherwise, would not have yielded ; 
as obstinate intermittents, wherein I have frequently employed the 
bark without effect : but on changing it for either the solution of 
arsenic, or vitriolic pills,* a cure has generally taken place, and when 
it did not, by exciting a slight mercurial action in the system and 
immediately following it with one or the other of the above medi- 
cines, I have pretty constantly succeeded. On this account medi- 
cines should never be made too free with, as preventives of disease, 
unless there be evidently a morbid predisposition lurking in the sys- 
tem : for, by thus wantonly familiarizing ourselves to medicine 
when there exists no necessity for it, we shall stand a very good 
chance to be disappointed of its proper effects, in the season of our 
need. 

Bitters, those especially made with spirits, like other cordials, have, 
no doubt, their use at times, as in damp weather, which hangs so 
heavily on the springs of life : but to use them, or mint slings, or 
drams, as some do every morning, even the brighest, when dumb 
nature herself is smiling, and every bird and beast are uttering their 
artless joy, is a species of suicide. It is a most wicked attempt to 
substitute artificial joys in place of those most pure and natural. 
Such an impious fighting against God and Nature, generally ends 
as might be expected. The wretched self destroyers seldom live 
out half their days. For the same delightful exhilaration, produced 
by one antifogmatic last year, requires two this year, and in that 
increase, till the habit of intemperate drinking is confirmed. How 
melancholy is it that rational beings should act so madly, and that 
the all bountiful Creator cannot intrust us with his good things, 
without our shameful abuse of them ! Thus it is, that men turn 
into poisons those pleasant beverages given for cordials, to raise 
their depressed spirits, to invigorate their flaccid nerves, and to ena- 

* Vid. Dispensatory. 



32 PRELIMINARY OBSERVATIONS. 

ble nature to repel the various attacks of a humid or infected at- 
mosphere. 

Among the many remedies of disease, none, perhaps, holds a higher 
place than the bath, in its different forms. The cold bath, by its 
sudden shock, is peculiarly fitted to invigorate the system, and to re- 
animate its circulations and secretions. Hence its acknowledged re- 
putation in all cases of weak and relaxed habits, particularly those 
of the studious and sedentary. 

It ought, however, to be remembered, that, like every other re- 
medy, it belongs but to one set of diseases. In affections of the vis- 
cera, obstructions and inflammations, it is hurtful. If after leaving 
the bath, the patient do not feel a kindly glow on the surface, he 
has good cause to fear that the angel of health was not there before 
him " to move the waters." On going into the plunging bath, as it 
is called, it were better to dash in at once head foremost. The shock 
in this way is more instantaneous, and the distributions of the blood 
more salutary than when it is driven, as by wetting the feet first, 
from the extremities to the head. It is on this principle that the 
shower bath possesses advantages superior to the plunging. Imme- 
diately on coming out of the bath, the body should be rubbed dry 
with flannel or coarse cloths, and moderate exercise taken. 

Besides the advantages of frequent cold bathing, its partial use is 
no less salutary in all cases of local action. In periodical headach, 
and, indeed, in most complaints of the head, the affusion of cold wa- 
ter, though a simple, is a very effectual remedy. 

If persons subject to the quincy and sore throat, instead of muf- 
fling their necks, would bathe them two or three times a day in 
cold water, they would find their account in it. When the healthy 
resort to the cold bath, on account of its purifying and pleasant ef- 
fects, they may continue in it for some time : but to strengthen and 
give elasticity to the solids, every thing depends upon the sudden 
shock. The time of the day for bathing is a matter of indifference, 
provided it be not immediately after a full meal, or when the body 
is warm and in a state of free perspiration. 

The rearm bath, about the temperature of the blood, has nearly 
all the advantages of the cold bath, without being liable to so many 
objections. Some, indeed, tell us, that it weakens the body; but so 
far from doing so, it may justly be considered as one of the most 
powerful and universal restoratives with which we are acquainted. 
Instead of heating, it cools the body, diminishes the pulse, and takes 
off its unnatural quickness, according to the length of time the bath 
is continued. Hence tepid baths are of great service, when the body 
has been over-heated, from whatever cause, whether by severe bo- 
dily or mental exercise. In all these cases, its happily composing 
and recuperative virtues seem to be owing to its tendency to promote 
perspiration, and to relax spasm. 

Warm bathing can hardly be sufficiently commended, for its sov- 
ereign effects in promoting cleanliness, and, consequently, for curing 
all diseases of obstructed perspiration from foul skin. 



OF THE STRUCTURE OF THE HUMAN MACHINE. 49 

trunk opens into the left ventricle of the heart : — Each of these 
divides into two branches. 

The lungs differ from every other part of the body in this respect : 
the wind-pipe, in its minutest ramifications, passes through all 
parts of its substance, terminating every where in air vesicles, for 
the grand purpose of perspiration, which keeps it in a continued 
state of action and reaction. Hence, when the lungs are diseased, 
their motion is not only increased by the respiration being quickened, 
but they suffer violent concussion by means of coughing. This 
circumstance renders disorders of the lungs more peculiarly difficult 
to cure. 

The Heart is a strong, active, indefatigable, muscular body, of a 
conical figure, included in an exceedingly strong membranous bag. 
called the pericardium, or heart purse, and situated in the cavity of 
the chest. It has two separate cavities, called ventricles, out of 
which issue the two large arteries of the human body, one called 
pulmonary, or artery of the lungs, the other aorta, or large artery of 
the body, from which all the other arteries go off, as branches of a 
tree from its trunk, dividing themselves into minute ramifications in 
their progress. Near the mouths of these two ventricles are two 
other hollows, which, from their similitude to dog's ears, are called 
auricles, into which the veins, returning from all parts of the body 
with the blood, through two large trunks or channels. It has two 
motions, called systole and diastole ; the former is when it contracts 
itself, and thereby forces the blood into the arteries. — The diastole 
is when it relaxes itself, and receives the blood from the veins. The 
ventricles of the heart are each capable of receiving an ounce of 
blood or more, and, therefore, being full in their diastole, we may 
suppose that they throw out, at least, one ounce of blood each 
systole. The heart contracts about four thousand times in an hour, 
more or less, according to the different temperaments, sexes, and 
ages; and, therefore, there pass through the heart, every hour, four 
thousand ounces, or two hundred and fifty pounds' weight of blood. 
Now, the common opinion is, that the whole mass of blood does not 
exceed twenty-five pounds, and, therefore, according to this allow- 
ance, a quantity of blood equal to the whole mass, passes through 
the heart ten times in an hour ; that is, about an ounce every second. 
If the heart contract eighty times in a minute, then twenty-five 
pounds' weight of blood pass through its ventricles once in five 
minutes, or twelve times in an hour. The farther the blood moves 
from the heart, its velocity decreases as the artery divides into more 
branches, so much so, that the blood moves 5233 times slower in 
some capillary arteries than it does in the aorta or great artery. 
The blood is received from the arteries into the veins, where it 
still moves more slowly as it returns to the heart again. The 
arteries are to the veins as 324 to 441, and, consequently, the 
blood moves in the veins above 7116 times slower than it does in 
the aorta. 

7 



50 OF THE STRUCTURE OF THE HUMAN MACHINE. 

The heart is the grand organ of the circulation of the blood, and 
consequently, of life. Impelled by this beating engine, part of the 
blood shoots upward ; and sweeps, with a bounding impetus, into 
the head. There it impregnates the prolific fields of the brain; 
and forms those subtile spiritous dews, which impart sense to every 
nerve, and communicate motion to every limb. — Part flows down- 
ward; rolls the recking current through all the lower quarters; and 
dispenses the nutrimental stores, even to the meanest member, and 
the minutest vessel. 

Observe, how the stately Thames, and the lordly Potomac 
refresh the forest and groves ; water the towns which crowd their 
banks ; and make the meadows they intersect, laugh and sing. — So, 
only with an incomparably richer fluid, and with infinitely more 
numerous streams, this human river laves the several regions of the 
body, transfusing vigour, and propagating health through the whole. 
The living flood never discontinues its interchangeable tide ; but, 
night and day, whether we sleep or wake, still perseveres to sally 
briskly through the arteries, and return softly through the veins. 

Such astonishing expedients are used to elaborate the chyle, to 
blend it with the blood, and to distribute both through the body, 
that the animal constitution is perfectly maintained. In youth, its 
bulk is increased ; in age, its decays are repaired ; and it is kept in 
tenantable condition for the soul during the space of seventy or 
eighty years. 

The doctrine taught by the immortal Harvey, the discoverer of 
the circulation of the blood, is, that all the veins of the body falling 
into two trunks, viz. the ascending and descending cava, empty 
themselves into the right auricle of the heart. The right auricle 
unloads into the right ventricle of the heart, which throws the blood 
through the pulmonary artery, into the lungs, by its two branches, 
which go to the right and left lobes. 

From the lungs the blood is brought back by the pulmonary veins, 
into the left auricle, and thence it passes into the left ventricle, from 
which it is distributed through the body by the aorta, or large artery 
and its branches. These terminate in the veins of the body, which 
collect the blood and bring it back to the heart, by the two cava, or 
large veins. 

In other words, the blood is conveyed from the left ventricle of 
the heart, by the aorta and its branches, to the minutest and most 
remote parts of the body, and then, passing from the extremities of 
the smallest arteries into the incipient veins, circulates through them 
into their larger branches, and so on into the right auricle of the 
heart, thence into the right ventricle, whence it is forced, with the 
fresh supplies that it receives from the chyle in passing through the 
subclavian vein, into the pulmonary artery, and, after circulating 
through, and being acted upon by the lungs, in its passage through 
them, is returned by the pulmonary vein into the left auricle, and 
thence into the left ventricle, and so on, the same round, until death 
concludes the progress. 



OF THE STRUCTURE OF THE HUMAN MACHI2 E. 51 

There is in the consideration of the organs performing the circu- 
lation of the blood, an air of grandeur that seizes forcibly on the 
mind, and penetrates it with the highest admiration. 

We perceive that the blood, every time it is returned to the right 
ventricle of the heart, is directly dispersed through the lungs, and 
immediately reconveyed to the heart, before it is permitted to begin 
a new circulation. In the study of nature throughout all her work, 
however complex the machine, the utility of each part ever claims 
the admiration of the speculative mind. 

The observation is beautifully illustrated on the present occasion, 
and " I believe it will be admitted by every one," says the ingenious 
author of the Medical Extracts, "that the blood, after having per- 
formed one round, throughout the animal economy, undergoes some 
new and important change in its transit through the lungs, especially 
requisite to support a second circulation. This change is certainly 
the oxygenation of the blood, and we should expect, if oxygen be 
the natural stimulus to the heart and arteries, that their pulsation 
would be in proportion as the blood had access to this principle." 

That animal heat depends upon the action of the arteries, and the 
circulation of the blood in general, is very natural to imagine ; be- 
cause whatever increases the velocity of the circulation, whether 
exercise, friction, or disease, also increases the internal heat; whereas, 
fainting, hemorrhage, and whatever produces a weak and languid 
circulation, also diminishes the heat of the body. 

When a ligature is put round an artery, so as to prevent the blood 
from being carried to any particular limb, that limb becomes colder 
than it was, and does not recover its natural heat, until, by removal 
of the ligature, or the expansion of the branches, which go off from 
above the ligature, the usual quantity of blood is circulated through 
the limb. 

With a new-born infant, the first thing is to infuse into its nostrils 
a the breath of life;" for until the lungs be expanded, and the venal 
or purple blood changed into arterial or crimson in that organ, the 
heart does not contract, nor the arteries vibrate ; like a clock not 
wound up, though sound in all its parts, remaining entirely at rest. 
In the clock, if we wind it up, the main-spring applying its powers, 
all the wheels are immediately put into motion, and it marks its 
hours and minutes ; so, likewise, in the animal machine, the blood 
in the lungs having imbibed the vital principle from the air, the 
heart acquires its actions, the brain its energy, the nerves their sen- 
sibility, and the other subordinate springs of life presently resume 
their respective functions. 

No organ can be severely affected without affecting the heart, 
and disturbing its functions ; nor can the heart be in the smallest 
degree affected, without disturbing every function of the animal 
economy. 

But the heart is not only affected by what injures the body, but 
also by what ruffles the mind. Rage occasions frequent and forcible 



52 OF THE STRUCTURE OF THE HUMAN MACHTNE. 

contractions; sorrow, slow and languid ones; and there are in- 
stances of violent passions suspending the contractions of the heart 
altogether, and occasioning death. The heart is not only affected 
by whatever hurts the body or mind of the person, to whom it 
belongs, but also by what hurts the bodies or minds of others. But 
the extent of this kind of sympathy differs greatly in different per- 
sons. In some it embraces children, friends, relations, countrymen, 
and in a certain degree, the whole human race ; in others, it seems 
to be entirely confined within the limits of their own bodies, or at 
most, reaches with a blunted sensibility no farther than to those 
whom they conceive to be their own offspring. While the blood is 
in circulation, various liquors are separated from it by a process 
called secretion, all these secretions being necessary for the health 
and preservation of animal life. When it is taken from the vein by 
the usual mode of bleeding, and left to itself, it soon congeals, and 
appears to be composed of two distinct parts, called crassamentum, 
or solid, and serum, or liquid. In a mass of healthy human blood, 
about one-half is crassamentum, which hath the red colour to itself. 
The serum in a healthy state is almost colourless ; at other times it 
is yellowish, or of a greenish hue, while the top of the crassamentum 
has different degrees of firmness, and puts on different appearances, 
with respect to colour, according to the constitution and health of 
the subject, from which it is taken. A due proportion of the re- 
spective parts of the blood is necessary to perfect health. 

The Diaphragm, or, Midriff, is a large thin broad muscle, that 
divides the breast from the behy. 

The uses of the midriff are, first to assist in respiration ; for, in 
taking in the breath, it is pressed downwards, and in expiration, it 
rises upwards into the cavity of the breast ; secondly, to assist the 
necessaiy motions of the stomach, intestines, liver, and spleen; and 
for assisting the expulsion of the faeces, the urine, the foetus, in 
parturition, of the secundines or after birth. — It marks our passions 
by its irregular actions, as sighing, yawning, coughing, laughing. 
It is affected by spasms, as in hiccough. 

The Abdomen, or Belly, lies between the breast and pelvis which 
is formed by the juncture of the haunch bones. 

The belly contains many of the principal parts of the human 
body, as the stomach, the intestines, liver, spleen, pancreas, kidneys, 
bladder, &c. On its inside, it is lined with a membrane called 
peritoneum, which is capable of a very great extension ; and after- 
wards can contract itself to its ordinary size, as we see in pregnane)^ 
dropsy, corpulency, and repletion. 

The Stomach may be considered a dilatation of the oesophagus or 
gullet, as it is a continuation of the same tube. Its figure nearly 
resembles the pouch of a bag-pipe, and has two orifices, the one 
above from the gullet, through which it receives the crude aliment, 
the other below, whereby it conveys the partially digested food or 
chyle into the duodenum. 



OF THE STRUCTURE OF THE HUMAN MACHINE. 53 

Before the food enters the gullet, it must of necessity pass over 
the orifice of the ivind-pipe ; consequently, must be in very imminent 
danger of falling upon the lungs, which would, if not entirely 
obstruct the breath, yet occasion violent coughing, and great incon- 
veniencies. To obviate this evil, the all-foreseeing Contriver has 
placed a moveable lid, or hung a cartilaginous draw-bridge ; which, 
when any of the smallest particle of food advances to enter the 
stomach, is pulled down, and shut close ; but the very moment the 
morsel is swallowed, it is set loose and stands open. By this two- 
fold artifice, the important passage is always barred and made sure 
against any noxious approaches; yet is always left free for the 
necessary accession of air, and commodious for the purpose of 
respiration. 

When the malster prepares his grain for the transmutation of the 
brew-house, he suffers it to lie several hours steeping in the cistern, 
before it is fit to be spread upon the floor, or dried on the kiln. The 
meat and drink likewise must remain a considerable time in the 
stomach before they are of a proper consistence and temperature, 
either for the tender coats, or the delicate operation of the bowels. 
For which purpose that great receiver is made strong to bear, capa- 
cious to hold, and so curiously contrived, as to lay a temporary 
embargo upon its contents. Here they are lodged in the very cen- 
tre of warmth, and concocted by the most kindly combination of 
heat and humidity. Here they are saturated with other fermenting 
or diluting juices; and are kneaded, as it were by the motion of 
the stomach, and compression of the neighbouring parts. So that 
every the minutest fragment is separated ; the whole is reduced to a 
tenuity abundantly finer than the exactest grinding could effect ; 
and all is worked up into the smoothest, most nicely mixed pulp 
imaginable. Prom hence it is dislodged by a gentle acting force, 
and passes by a gradual transition, into the cavity of the intestines. 

The Intestines form one continued canal from the stomach to the 
anus, which is usually five or six times the length of the individual. 
It is curiously convoluted in the abdomen, and is extremely irrita- 
ble. Although one entire tube, anatomists have divided it into the 
email and great intestines. The small intestines are called duo- 
denum, jejunum, and ilium; the larger are the caecum, colon, and 
rectum. 

The Duodenum, so called because it is generally twelve inches 
long in adults, is the widest and shortest of the small intestines. At 
a short distance from where it joins the stomach, it receives two 
ducts, the one from the liver bringing the bile, and the other from 
the pancreas, or sweet bread, bringing its liquor to complete the 
digestion of the food. The second gut is the jejunum, so called, 
from its being usually found empty, its numerous lacteal vessels 
having absorbed the chyle. 

The Ilium is the third and last of the small intestines. The 
great length of the small guts is evidently for the convenience of a 



54 OF THE STRUCTURE OF THE HUMAN MACHINE. 

great number of lacteals, that the chyle which misses their orifices 
in one place may not escape them in another. 

The Ccecwn, or blind gut, is a pouch, as it were of the Colon, 
about three inches long, and called blind, from its being out of the 
direction of the passage of the food. 

The Colon is the greatest and widest of all the intestines, about 
eight or nine hands' breadth long, and by lying so contiguous to all 
the bowels, it communicates all the benefits of the injections thrown 
into it. 

When the colon is affected, there is a sense of weight, though 
the pain is not very acute ; whereas in the small guts there is not 
any sense of weight, but an acute pain. Sometimes a pain in the 
colon, attended with fever, the pain extending to the ribs, gives a 
suspicion of pleurisy, though the colon only is affected. The colon 
is narrower on the right side than elsewhere, whence colic pains 
arise more frequently, and are more severe in this part. — The excre- 
ments are long retained here, and often are much indurated before 
they pass farther on. 

The Rectum, or straight gut, is about a hand's breadth and a 
half long. It begins where the last curvature of the colon ends, 
and is terminated at the fundament. At its termination it is sur- 
rounded by circular muscular fibres, called the sphincter ani, to 
retain the faeces. 

The intestines are not left to move at random in the cavity of the 
abdomen, but are artfully tied down by a membraneous web, which 
prevents their circumvolutions from being entangled in each other, 
at the same time allowing a gentle, but animated motion. That 
part of it connected with the small intestines is called messentery, 
the other part fastened to the colon, mesocolon. All the intestines 
have in their inner membrane an almost infinite number of very 
small giands, whose office it is to discharge into the intestines a 
liquor for the attenuation of the chyle, for lubricating the intestines, 
and in the large guts to soften the faeces, that they may be evacuated 
without pain. The intestinal canal serves to complete the first 
digestion, strain off the chyle, and carry off the fseces. 

Had the intestines been straight and short, the food might have 
gone through them, without resigning a sufficient quantity of its 
nourishing particles. Therefore, this grandest of all the vital ducts 
is artfully convolved, and greatly extended, to afford an opportunity 
of sifting more thoroughly whatever passes, and of detaining what- 
ever may serve its purposes. Though the alimentary substance can 
never mistake its way, yet it may, through some accidental impedi- 
ment, attempt to return backward. In this case a valve intervenes and 
renders what would be extremely pernicious almost impracticable. 

Upon a survey of the use of the stomach and intestines, we can- 
not avoid being struck with wonder at its apparent simplicity 
answering so many salutary purposes. As soon as we take our food, 
it is received into a place in all points calculated to render it fit for 



OF THE STRUCTURE OF THE HUMAN MACHINE. 55 

yielding its nutritious contents. At first, the food taken into the 
stomach, retaining its peculiar properties, irritates the coat of that 
organ and occasions a contraction of its two orifices. The food, 
thus confined, then undergoes a constant agitation by means of the 
abdominal muscles, and of the diaphragm, and by the motion of 
the fibres of the stomach, itself. By these movements, every part 
of the food is exposed to the action of a fluid secreted in the sto- 
mach, called the gastric juice, which gradually dissolves and attenu- 
ates the food, and prepares it for its passage into and farther change 
in the intestines. 

The painful sensation of hunger, which is the irritation of the 
gastric juice on the coat of the stomach, or a sensation of a defective 
supply of chyle in the arterial system, being removed by the food, 
we soon feel a mild and undescribable delight, first, from the stimu- 
lus of the aliment; and secondly, from the distension of this, and 
the increased action of other parts. 

The aliment having remained during two or more hours in the 
stomach, is converted first into a grayish pulp, which is called chyle. 
This fluid passes out of the right orifice, the fibres of which relax 
to allow it to escape ; while the grosser and less altered particles 
remain in the stomach till they acquire a sufficient fluidity to pass 
into the intestinal canal. As the digested food enters the duo- 
denum, it stimulates the common duct of the gall-bladder, from 
which it receives a full supply of bile and of saliva, secreted from 
the pancreas. 

The Chyle, drawn off by all the secretory orifices, is carried 
along millions of the finest ducts, and lodged in several commodious 
cells. As a traveller, by taking proper refreshments on the road, is 
better qualified to pursue his journey; so the chyle, diverted to 
those little inns, is mixed with a thin, diluting watery substance, 
which renders it more apt to flow, and more fit for use. Hence it 
is conveyed to one common receptacle, and mounts through a per- 
pendicular tube. When provision or ammunition is transmitted to 
an army, it generally passes under an escort of able troops. As this 
is the immediate support and principal nourishment of the whole 
system, its conveyance is guarded with peculiar caution. The jper- 
pendicular vessel that conveys it, not having sufficient force of its 
own, is laid contiguous to the great artery, whose strong pulsation 
drives on the creeping fluid, enables it to overcome the steep ascent, 
and unload its precious treasure at the very door of the heart. Here 
it enters the trunk of a large vein, secured by a valve, admirably 
constructed to prevent the refluent blood, in case it should oiler to 
return, and opening a free, safe, and easy avenue to introduce this 
milk, this manna of nature. 

The Blood, through every stage of its simple circuit, having sus- 
tained great expenses; being laid under contribution by every gland 
in the whole system ; and having supplied myriads of the capillary 
vessels with matter for insensible perspiration, must be very much 



56 OF THE STRUCTURE OF THE HUMAN MACHINE. 

impoverished; but is most opportunely recruited by this accession 
of chyle. 

Besides the uses above specified, appropriated to the stomach and 
intestines, there is another very considerable bestowed, particularly 
on the former, by which impressions are diffused to almost every 
part of the machine, and from which all the sensible parts receive 
very peculiar and extraordinary advantages ; namely, conveying 
action to different parts, and feeling the effect from these sympa- 
thetically and instantaneously. For instance, a glass of wine or 
brandy, received into the stomach of a person exhausted with fatigue 
and ready to faint, gives instantaneous spirits and fresh vigour. 
This must proceed from the affection of the nerves of the stomach, 
and their sympathy with the rest of the body, as there is not time 
for the liquor to be conveyed into the blood in the usual manner. 

The Stomach universally sympathizes with other parts of the 
body. A blow on the head occasions vomiting. A disordered 
stomach often excites a headach. The headach, which is apt to 
come after drinking too much wine, or other strong liquors, certainly 
proceeds from the stomach, and sometimes is diminished or entirely 
removed by a dram. A stomach disordered by indigestion is often 
accompanied with flushings in the face, palpitations at the heart, 
difficult breathings, dejection of spirits, uncommon sensibility, and 
with giddiness. 

The Omentum, or Caul, is a fine membrane like net-work, 
larded with fat. It is situated under the peritoneum, and immedi- 
ately above the intestines, on the surface, resembling an apron 
tucked up. It serves to lubricate the intestines, that they may the 
easier perform their peristaltic motion, to cherish and defend them 
from cold, and to assist in the formation of the bile. It serves also 
to temper the acrimony of the humours, and probably to give nour- 
ishment to the body, as all the other fat is supposed to do, when it 
isjncapable of being nourished any other way. 

The Liver, situated immediately below the diaphragm or midriff, 
on the right side, reaches as far back almost as the spine or back- 
bone, and rests upon the right kidney. It is the largest gland in the 
body, and is divided into two unequal parts, called lobes. Except 
for the vessels, which are very numerous, the liver would be very 
soft, and like a piece of congealed blood. 

The great use of the liver is to secrete the bile. It is the seat 
of various disorders, inflammation, abscess, schirrhus, &c, and in 
most of them, the countenance hath a pale colour, or a yellowish 
one with a green cast. There is one circumstance not much at- 
tended to with respect to the situation of the liver ; its large or right 
lobe occupies the whole half of the belly, where it lies from the 
spine to the inside of the ribs, laying over the upper part of the kid- 
neys. Now this position of the liver is not often considered, for, 
when one has a pain in the small of the back, it is said to be in the 
kidneys ; but if it be a little higher up in the back, it is seldom, if 



OF THE STRUCTURE OF THE HUMAN MACHINE. 57 

ever thought to be in the liver, though it most undoubtedly may, as 
its posterior edge lays on that part, on the right side. 

The Gall- Bladder, or receptacle of bile, is fixed to the under 
side of the liver. Punctual as a porter in his lodge, it waits ready 
to pour its acrimonious, but salutary juices on the aliment, as it 
advances from the stomach ; which dissolve its remaining viscidities, 
support the peristaltic motion of the intestines, and greatly assist in 
completing the digestion. 

Such is the importance of the bile in our constitution, and the ill 
consequence of an error in it, that every aid is desirable, by which 
our knowledge of its nature can be promoted. When there is a 
defect of bile, it disposes the body to various diseases; as melan- 
choly, indigestion, and obstruction of the viscera, &c. When there 
is a redundancy of bile, or it offends the stomach by its acrimony, 
it causes chilliness, shivering, and great anxiety. — It is certain, that 
in fevers the bile is not only plentifully generated, but peccant in 
its quality; and if not duly evacuated must be productive of many 
disagreeable symptoms ; hence the importance of a soluble belly in 
febrile disorders. 

The Pancreas, or Sweet Bread, a large gland, situated near the 
stomach, serves to secrete a liquor like the saliva, which is discharged, 
by a short duct into the duodenum. 

The Spleen is situated under the cartilages of the ]eft short ribs. 
In its natural and sound state, it is about six or seven inches long, 
about three in breadth, and one in thickness. It often becomes 
scirrhous and considerably enlarged in persons who have been 
frequently attacked with intermittent. Its use is not precisely 
known. 

The Kidneys are two oval bodies, situated in the loins, contigu- 
ous to the two last short ribs ; the right under the liver, and the left 
under the spleen. They separate the urine from the blood. 

The Ureters are tubes about the size of goose quills, and about 
a foot long ; rising from the kidneys, and entering the bladder near 
its neck. They form to themselves, as it were, valves, so that upon 
the contraction of the bladder, the urine is ejected through the 
urethra, its proper passage. 

The Bladder is a membranous and fleshy sack or bag, capable 
of contraction and dilatation, situated in the lower part of the belly. 
Around its neck, which is longer in men than in women, there goes 
a small sphincter muscle to contract the orifice, that the urine may 
not be involuntarily discharged. The use of the bladder is to receive 
the urine, perpetually secreted into it from the kidneys. 

The Uterus, or Womb, between the urinary bladder and (he 
rectum, or straight gut, is placed by Divine Wisdom, in a situation 
of great security, called the pelvis or basin, being guarded on all 
sides by the strong bones that form the basis of the trunk. In 
figure, it very much resembles a pear, its broadest extremity, which 
is called its bottom, is uppermost, and its small part, the neck, is 
8 



58 OP THE STRUCTURE OF THE HUMAN MACHINE. 

downwards. The womb, when impregnated, hath a very small 
cavity, but becomes larger as pregnancy advances, and, in the time 
of delivery, has its mouth wonderfully dilated, so as to give passage 
to the child. 

About the age of puberty, the blood vessels of the uterus become 
distended, and secrete monthly a fluid called menses, catamenia, 
and vulgarly, flowers, courses. 

The Vagina, or Neck of the Womb, extends from the mouth of 
the uterus to the pudendum or external parts. In women it enlarges, 
and, like the uterus, in the time of birth, dilates very much. Just 
within the vagina is the orifice of the urethra, which is shorter, 
wider, and straighter than in men. 

Beside the womb and vagina, there are two other contrivances, 
supposed to perform particular functions, in the propagation and 
formation of our species, the one called ovaria, from their retaining 
small round substances of the nature of eggs, the other Fallopian 
tubes, from their discoverer, Fallopius. 

The Fallopian Tubes are situated on the right and left sides of 
the womb. They rise from its bottom by a narrow beginning, and 
dilate in the form of a trumpet to their extremities at the ovaria. 
Their cavity, where they open into the womb, will scarcely admit 
of a hog's bristle ; but at its widest part, it will take in the end of 
one's little finger. The tubes are about four or five finger's breadth 
long. 

They serve to convey from the ovaries the rudiments of the foetus 
to the womb, where they are farther developed and perfected. 

The Ovaria, or Ovaries, are two small bodies, situated on each 
side of the fundus uteri, or bottom of the womb behind the Fallo- 
pian tubes. At the age of puberty they are full and plump, and 
continue so until the menses are about to depart. They contain 
from ten to twenty or more pellucid eggs, supposed to contain the 
primordia of the foetus. 

The Testes, or Testicles, are two oval glandular bodies, seated 
in the scrotum, which serve to secrete the semen from the blood. 
The scrotum, or external covering, is made up of the scarf skin, 
true skin, and immediately under the latter, is a thick cellular tex- 
ture closely adhering to it. It is likewise composed of many fleshy, 
or muscular fibres, by means of which the scrotum is contracted, 
and is reckoned a sign of health. 

The Prostrate Gland is situated at the neck of the bladder; and 
is about the bigness of a walnut. By some it is supposed to secrete 
a fluid merely to lubricate the urethra, and by others it is deemed 
subservient to the process of generation. 

The Urethra is a canal or pipe of the thickness of a goose quill, 
and about twelve or thirteen inches long, which begins at the neck 
of the bladder, and terminates at the end of the penis. Its inner 
membrane furnishes a mucilaginous liquor, serving to defend it 
against the acrimony of the urine. 



OF THE STRUCTURE OF THE HUMAN MACHINE. 59 

The Penis is composed of two spongious bodies, part of the 
urethra, the glands or nut at its extremity, and its integuments. — 
The spongious bodies take their name from being porous like 
sponge, and capable of being distended and enlarged by the blood 
penetrating their substance, as in case of erection. The integu- 
ments of the penis make a hood to the glands or nut of the yard, 
called prepuce or foreskin. The small ligament, by which it is tied 
to the under side of the nut, is called freenum. The use of the 
prepuce or foreskin, is to keep the nut soft and moist, and to pre- 
serve its sensibility. The amputation of it constitutes circumcision, 
a practice recommended by Moses to the Jews. 

We shall now conclude the anatomical part of the human body, 
and trust enough has been said, concise as it is, to give to the unin- 
formed readers, just conceptions of the most important parts of the 
human machine, and its natural action. 

We see the greatest multiplicity of parts, yet the most perfect 
harmony subsists between them all. No one hinders, but each 
assists the operation of another, and all conspire to the benefit and 
preservation of the whole. Most judiciously has the great apostle 
touched this subject; and most happily applied it to illustrate the 
reasonableness, and enforce the practice, both of personal and social 
duties, of private content, and public concord. 

The body, he observes, is not one member ', but many, to each of 
which some peculiar and needful office is assigned; so that the foot, 
though placed in the lowest order, and destined to serve on the very 
ground, has no reason to reckon itself a worthless outcast ; or to say, 
Because I am not the head, I am, not of the body. Neither has the 
head, in its exalted station, and amidst its honourable functions, 
any cause to despise the inferior limbs ; or to say, with contempt 
and self-sufficiency, I have no need of you. — If there were no feet, 
what would become of the locomotive faculty ? or how could the 
body convey itself from one place to another? If there were no 
hands, what should we do for the instrument of action? or how 
could the animal frame be defended and accommodated ? Nay, the 
parts which seem to be less honourable, are necessary. Even those 
which form the sediments, or throw off the dregs, are of importance 
to life and its comforts. Should those be obstructed in their action, 
the most raging torment ensues; and should the obstruction con- 
tinue, death is the inevitable consequence. — By this wise adjust- 
ment, there is no schism in the body, no separate or interfering ends 
pursued by the members, but the safety and support of each are the 
one undivided care of all. 

Wise, wonderfully wise and eminently gracious, is the regulation 
both of spontaneous and involuntary motion. Were this regulation 
reversed, what deplorable inconveniencies would take place ; Day, 
what unavoidable ruin must ensue ! Deplorable inconveniencies ; 
if the discharges of the bowels, or evacuations of the bladder, were 
quite independent of our leave. Unavoidable ruin ; if the action 



60 OF THE STRUCTURE OF THE HUMAN MACHINE. 

of the heart required the co-operation of our thoughts, or the business 
of respiration waited for the concurrence of our will. 

The will, in some cases, has not so much as a single vote. In 
others, she determines and commands like an absolute sovereign ; 
nor is there a monarch upon earth so punctually obeyed, as this 
queen of the human system. If she but intimate her pleasure, the 
spirits run, they fly to execute her orders; to stretch the arm, or 
close the hand; to furrow the brow with frowns, or dimple the 
cheek with smiles. How easily , as well as punctually, are these 
orders carried into execution ! To turn the screw, or work the 
lever, is laborious and wearisome ; but we move the vertebrae, with 
all their apparent chambers ; we advance the leg, with the whole 
incumbent body; we rise from our seat; we spring from the 
ground ; and, though much force is exerted, though a very con- 
siderable weight is raised, we meet with no difficulty, we complain 
of no fatigue. 

That all this should be effected without any toil, and by a bare 
act of the will, is veiy surprising : but that these motions should be 
made, renewed, continued, even while we remain entirely ignorant 
of the manner in which they are performed, is beyond measure 
astonishing. Who can play even a single tune upon the piano, 
without learning the difference of the keys, or studying the rudi- 
ments of music? Impossible ! Yet the mind of man touches every 
string of the human machine with the most masterly skill, though 
she knows nothing at all concerning the nature of her implements, 
or the process of her operations. We walk, we run, we leap, we 
throw ourselves into a variety of postures, and perform a multitude 
of motions, yet are utterly unable to say which nerve should be 
active ; what muscles should swell, or what tendons approximate. 

Put a German flute into the hand even of a sensible person ; with- 
out a master to instruct him, he is at a loss to make the instrument 
speak ; much less is he able to sink and soften the sound, to exalt and 
extend it just as he pleases. Yet we are self-taught in the method of 
forming, regulating, and varying the voice. Naturally, and with 
unpremeditated fluency, we give it the languishing cadence of 
sorrow, or the sprightly airs of joy; the low faltering accents of fear, 
or the elated tone, and rapid sallies of anger. We can never suffi- 
ciently admire this multiplicity of animated organs ; their finished 
form, and their faultless order. — Yet I must confess myself struck 
with greater admiration at the power, the truly mysterious power 
and sway which the soul exercises over them. Ten thousand reins 
are put into her hand ; she is not acquainted with their office, their 
use or their name : she has not learned so much as to distinguish one 
from another, nevertheless she manages all, conducts all without the 
least perplexity, or the least irregularity ; rather with a promptitude, 
a consistency, and a speed, which nothing else can equal ! Since 
health depends upon such a numerous assemblage of moving organs ; 
since a single secretion stopped, may destroy the salu.tary state of the 



OF THE STRUCTURE OF THE HUMAN MACHINE. 61 

fluids, or a single wheel clogged, may put an end to the vital motion 
of the solids ; with what holy fear should we pass the time of our 
sojourning here below I trusting for continual preservation, not 
merely to our own care, but to that omnipotent hand which formed 
the admirable machine: that the same hand which formed it, may 
superintend its agency and support its being. 

When we consider the extensive contrivance and delicate me- 
chanism — what plans of geometry have been laid ; what operations 
of chemistry are performed ; in a word, what miracles of art and 
elegance are executed, in order to furnish us with the necessary 
recruits and the several delights of life — is there not abundant reason 
to cry out with the inspired writer, " How dear are thy counsels 
unto me, O God!" thy counsels of creating wisdom! Thou hasi 
not been sparing, but even lavish of thy indulgent designs ! Thou 
hast omitted no expedient which might establish my ease, enlarge 
my comforts, and promote, yea complete, my bodily happiness ! and 
is not this a most endearing obligation to glorify the blessed God 
with our bodies, as tvell as ivith our spirits 9 

The mechanism of our body ; the connexion and subserviency of 
all its parts to a common purpose ; the exquisite contrivance of its 
organs, consisting of such various minute vessels, interwoven with 
wonderful art, have led anatomists of all ages, to acknowledge an 
infinite, wise and powerful Maker. Among the most precious 
remains of antiquity, are those commentaries of Galen, written on 
the uses of the several parts of the human body, as hymns and 
offerings of praise to the great Creator. 

Is it, indeed, otherwise conceivable how such consistency and 
harmony could have taken place in the different parts of our won- 
derful frame ? How they could have been so exactly fitted to each 
other, and to the exterior objects which have an evident relation to 
them, and the system they compose? Could the bones, which in 
all amount to four hundred, and the muscles, still more numerous, 
and each so well disposed for motion, be adjusted without a superior 
knowledge in mechanics? The eye, so admirably adapted to light, 
and appropriated to vision, was it formed without a knowledge of 
optics? Or the ear, without the science of sounds? Even our 
inclinations and passions, those sources of so much apparent ill, are 
by the Deity providentially rendered the means of our preservation. 
both as individuals and a race ; and the selfish and social affections, 
like centripetal and centrifugal forces, conduct us with proper force, 
to the end intended by our Maker to be produced by them. Yet 
the love of life and all its enjoyments, the fear of death and all its 
dreadful harbingers, and the social affections and all their endear- 
ments, would not have been sufficient security for our carrying on 
the vital motions with that constancy and uniformity necessary to 
the preservation of life, if thus engaged these motions had depended 
upon our will and choice. Reason would have deliberated con- 
cerning them with too much slowness, and volition would have 



62 OP THE STRUCTURE OF THE HUMAN MACHINE. 

executed often with a dangerous and fatal caprice. For, if the 
heart had been subject to the soul's authority, as much as the volun- 
tary muscles are ; if its motions could have been suspended or 
stopped with the same facility, death would then have cost us no 
painful pang; and whenever the body was tortured with disease, 
and the mind in anguish from grief or disappointment, a remedy so 
easily applied might have been too frequently resorted to, and yet 
more unfortunate beings might have rushed uncalled into the 
presence of Him who stationed us for the wisest reasons here on 
earth. — The preservation of life, therefore, greatly depends on our 
vital motions being entirely subject to the wise government of the 
Author of our lives, who charges Himself with the immediate care 
of them and of us. All this, when attentively considered, must 
affect us with a sense of God's goodness; who, respecting the 
imbecility of man's nature, hath been pleased, by appetites and 
passions, to excite him to acts of self-preservation ; where the vio 
lence of these might have been hurtful, no less than the slowness 
and instability of reason, hath taken our safety under his more 
immediate direction. To attribute contrivances like these, and even 
understanding itself, to unintelligent causes, rather than to the all 
wise Parent of Nature, seems an incomprehensible perversion of 
reason and philosophy. That mind must be strongly prepossessed 
and bewildered with false science, which rather seeks for the cause 
of these involuntary motions in dead matter, organization, chance, 
necessity, something that, without knowledge or power, acts wisely 
and powerfully, than in the great Fountain of power, wisdom, and 
animation. 

If chance could be supposed to produce a regular determinate 
action, yet it is beyond the highest degree of credulity, to suppose it 
could continue this regularity for any time. But we find it remains 
through life, independent of our own will ; and the same incessant 
vital actions have been carried on from the commencement of the 
world. It is thus that the sun's influence upon the earth hath ever 
been regular. The production of trees, plants, and herbs ever 
uniform. Every seed produces now the same fruit it ever did. 
Every species of animal life is still the same. Could chance 
continue this regular arrangement 9 Could any thing continue it, 
but the hand of an Omnipotent Creator? 

The human body is exalted to a most intimate and personal union 
with the eternal Son of God. He who decorated the heaven with 
stars, and crowned the stars with lustre ; He vouchsafed to be made 
flesh, and was found in fashion as a man. Nay, this is even noxo 
the apparel of that divine and adorable person. He is clothed 
with our nature ; he wears our very limbs; and appears in the dress 
of humanity, even at the right hand of God, and at the head of all 
the heavenly hosts. 

What think you of another privilege mentioned by the Apostle ? 
" Your bodies are the temple of the Holy Ghost." Not your 



OF THE STRUCTURE OF THE HUMAN MACHINE. 63 

souls only, but your very bodies are the shrine in which the high 
and holy one ? that inhabiteth eternity, condescends to dwell. 
He, who sitteth between the cherubim and walketh in the circuit of 
the skies, is pleased to sanctify these earthly tenements for his own 
habitation. And is not this a much grander embellishment, than 
all their matchless contrivance and masterly workmanship ? 

Nor must I omit the dignity- the transcendent dignity, which is 
reserved for these systems of flesh at the resurrection of the just. 
They will then be refined and improved into the most perfect state, 
and the most beauteous form ; surpassing whatever is resplendent 
and amiable in the most ornamental appearances of material nature. 
They will be purer than the unspotted firmament ; brighter than the 
lustre of the stars ; and, which exceeds all parallel, which compre- 
hends all perfection, they will be made like unto Christ's glorious 
body ; like that incomparably glorious body which the blessed Jesus 
wears in his celestial kingdom, and on his triumphant throne. 

When we add all these magnificent prerogatives which are re- 
vealed in Scripture, to all those inimitable niceties which are dis- 
played by anatomists, what thankfulness, what admiration can equal 
such a profusion of favours? 

Say, why was man so eminently rais'd 

Amid the vast creation, why ordain'd 

Through life and death to dart his piercing eye 

With thoughts beyond the limit of his frame ? 

But that the Omnipotent might send him forth, 

In sight of mortal and immortal powers, 

As on a boundless theatre, to run 

The great career of justice; to exalt 

His generous aim to all diviner deeds ; 

To chase each partial purpose from his breast, 

And through the tossing tide of chance and pain, 

To hold his course unfaltering, while the voice 

Of Truth and Virtue up the steep ascent 

Of nature, call him to his high reward 

The applauding smile of Heaven. — Akenside. 



ON 



hygieine; 



THE ART OF PRESERVING HEALTH 



Reason's whole pleasure, all the joys of sense, 

Lie in three words — Health, Peace, and Competence. 

But Health consists of temperance alone, 

And Peace, O Virtue, Peace is all thy own. — Pope. 

In the preceding chapter I have treated of the structure of the 
Human Body. I shall now show, that by due attention to the 
" Non-naturals," air, food, exercise, sleep, evacuations, mid. passions, 
we may go far to preserve this fabric in good health from the cradle 
to the grave. Nay, so wonderful is the body in its resources, its 
powers of renovation ; and so sovereign are the virtues of the Non- 
naturals, that thousands are the instances of persons who, after hav- 
ing their health apparently ruined by an abuse of them, have, on 
returning to a wise and temperate use, entirely recovered their health, 
and attained to a most active and happy old age. Hence, the reason 
mankind are so often sick, is because they so often err in the use of 
these, the appointed preservatives of life and health. 

To inculcate this truth more universally, I have introduced these 
disquisitions on the art of preserving health, and, to render them 
more acceptable to my readers, have enlivened them with appro- 
priate illustrations, hoping thereby to make impressions as lasting 
as they are important. 



PRELIMINARY OBSERVATIONS. 33 

It is much to be lamented that so many poor children should be- 
come the victims of their parents' laziness, and neglect of the most 
sweet and healthful virtue, cleanliness. For, would they devote a 
little of their mispent time and money to the more decent clothing 
and frequent washing of their children, there could be no doubt that 
the little innocents would enjoy ten thousand times more comfort 
than they can possibly have while covered with filth, and tortured 
with scald heads, blotches, itch, and vermin. In fine, having seen 
the fatal termination of so many diseases, in my opinion, easily cu- 
rable by the bath, I cannot dismisss this important subject without 
earnestly recommending it to every gentleman to provide for his 
family the convenience of bathing, as not only one of the greatest 
luxuries, but the best preservative of health in these warm climates. 

It is essential to health, luxuriously to refresh the person by bath- 
ing and washing off the impurities of the skin : and equal care should 
be taken to remove all filth out of the chambers of the sick; and 
frequently to change their linen and bed-clothes, which, when satu- 
rated with fetid .and perspirable matter, must prove extremely un- 
pleasant and hurtful to the patient. 

And here I cannot but breathe the most fervent wish that the 
agriculturist of the south and west, would be persuaded to insist more 
rigorously on cleanliness in the person of their slaves. That the 
constitution of the African is more firm than ours, and better fitted 
to sustain the toils of warm climates, is very certain ; but it is equally 
true that his daily labours with the sudden changes of weather, often 
put his constitution, good as it may be, to trials which loudly call 
for every aid that humanity can possibly afford him. Of these aids, 
next to plenty of wholesome food, cleanliness is one of the greatest. 
It is, indeed, a medicine both of body and mind. The poorest 
slave, however degraded his condition may be, has still left a portion 
of mind, which can never be totally insensible to his outward ap- 
pearance. Cover him with rags and filth, and you not only injure 
his body by obstructing perspiration and corrupting the fluids, but 
you attack him in his mind. Knowing that he appears vile and 
loathsome to others, he becomes much more so to himself; and this 
idea imbitters reflection, depresses his spirits, and, in conjunction 
with other causes, often brings on diseases which press him to an 
untimely grave. Whereas, by ordering him frequently to bathe, 
and by affording him three changes of apparal, of which one might 
always be clean, he would be greatly refreshed and comforted, both 
in mind and body. Thinking his appearance decent in the eyes of 
others, he becomes well pleased with himself, and looking on his 
new habit, however cheap and simple, as an evidence of his master's 
affection and value for him, he feels at once the touch of an honest 
pride in himself, and of friendship for his master, which lightens his 
task and sweetens all his toils. 

But, if cleanliness be of such importance to the healthful, how 
much more so to the sick slave. When sinking under the heat and 
5 



34 PRELIMINARY OBSERVATIONS. 

burden of his labours, can it be good policy to suffer him to be put, 
like a mere animal, into a narrow dirty cabin ; there left, with scarcely 
a child to hand him " a cup of cold water" with no food but dry 
bread, and breathing the fetid atmosphere of a sultry, filthy, habita- 
tion! In such circumstances, what, but a miracle, can save him 
from destruction? 

Having been frequently an eye witness of such scenes, of which 
the owner himself was, perhaps, ignorant, I feel it my duty to advise 
him, not only for humanity, but interest sake, to erect for his slaves, 
especially if he have many, a cheap, coarse kind of building as an 
hospital. This building should be fixed on some spot, enjoying, in 
the highest degree, the double advantage of good water and air. It 
ought to consist of but one large room, quite open to the top, well 
aired by doors, and windows, and with a plank floor, that it may be 
frequently washed and kept perfectly clean. Some good-tem- 
pered, notable old woman of the family, should be appointed to 
attend the sick, and supply the proper nourishment. In this cheap 
and simple way, many a valuable slave might, we are certain, be 
saved to his owner, which, alone, were an ample reward, without 
counting the present comfort of such humanity, or the future bless- 
ings of Him, who has promised that every act of love, even to the 
poorest slave, shall be remembered as if done to himself. To the 
truly wonderful effects of this regimen, embracing cleanliness, fresh 
air, good nursing and diet, I, myself, can bear the most public and 
unequivocal testimony. 

In the year 1805, when the summer and autumnal fever raged 
with uncommon violence and mortality in Savannah, having con- 
siderable practice among the shipping, I was induced, chiefly from 
motives of humanity, to open a private hospital for seamen. And 
though I had usually from twenty to thirty patients during the 
sickly season, I lost but one of all who had been taken into the hos- 
pital at an early stage of the disease. This extraordinary success, 
I ascribed, in a great measure, to the virtues of the regimen above 
recommended. And, in support of the plan recommended, I 
will venture to assert, that hardly an instance can be quoted of 
the recovery of seamen, when left neglected, or badly attended, in 
the confined boarding-rooms, or steerages of the ships, where they 
were attacked. 

The very happy result of the little hospital system above stated, 
cannot but excite the most earnest wish for a similar establishment, 
in Savannah, on a much larger scale. Such an institution could 
not fail to prove a great blessing to the state, but more so to the 
town, where numbers of useful citizens, especially seamen, are an- 
nually swept off. 

It affords me pleasure to state, that since the appearance of this 
friendly hint, in the first edition of this work, the humane citizens 
of Savannah, have actually established a public hospital, and have 
found it abundantly productive of the good effects predicted. For 



PRELIMINARY OBSERVATIONS. 35 

tunate would it be, if similar institutions were erected in all our 
sea-ports. In addition to the softer whispers of humanity, grati- 
tude now lifts her louder voice ; for surely our gallant sailors, prin- 
cipally the objects of such hospitals, have given glorious proofs in 
the late awful contest, that they deserve every mark of attention 
that a great nation in the plenitude of munificence can bestow. 



OF THE STRUCTURE 



OF 



THE HUMAN MACHINE 



How poor, how rich, how abject, how august; 

How complicate, how wonderful is man! 

How passing wonder He who made him such! 

Who centred in our make such strange extremes! 

From different natures, marvellously mixed! 

An heir of glory ! a frail child of dust ! 

Helpless immortal! insect infinite! 

A worm! a God! — I tremble at myself, 

And in myself am lost. Young. 

" / am fearfully and wonderfully made, O Lord" exclaimed 
David, on surveying the admirable mechanism of his own frame. 
Indeed, so complicated and curious is the structure of the human 
frame, that no person, who contemplates it, can possibly avoid join- 
ing with the pious Psalmist. 

That illustrious physician of antiquity, Galen, is reported in his 
youth to have been a sceptic, but on witnessing a dissection, and ex- 
amining the mechanism of the human body, the divine wisdom and 
design running through all its parts, he was struck with such a 
sense of the great Architect, that he immediately became a convert, 
and during his life devoted himself to the worship of the Deity with 
all the fervour becoming an enlightened and grateful mind. Having 
himself happily caught the first spark of Divine light from a survey 
of this wonderful machine, he earnestly recommends to others the 
study of it as the noblest employment of the faculties, and one of the 
surest guides to rational devotion. His thoughts on this subject, 
though emanating from a heathen, are well worth the attention of 
all Christians. — " Those treatises," says he, ".which display the ex- 
cellencies of the great Creator, compose one of the noblest and 
most acceptable hymns. To acquaint ourselves with his sublime 
perfections, and point out to others his infinite power, his unerring 
wisdom, and his boundless BENiGNiTY^-this is a more substantial 
act of devotion, than to slay hecatombs of victims at his altar, or 
kindle mountains of spices into incense." 



OF THE STRUCTURE OF THE HUMAN MACHINE. i7 

Now, as one object of the "Medical Companion" is to treat o. the 
art of preserving this divine piece of workmanship in a healthy state, 
nothing can impress us more forcibly than the absolute necessity of 
being made acquainted with its parts, and the laws that govern 
them: without some knowledge thereof, it appears no more possible 
to take the right care of it, or to keep it in good order, than to per- 
petuate the regular motion of a clock, or time-piece, without a 
familiar acquaintance with its mechanism. 

The study of Anatomy, as it leads to the knowledge of nature, 
needs not, says the illustrious Cheselden, many tedious descriptions, 
nor minute dissections, what is most worth knowing being soonest 
learned, and least subject to difficulty ; while dividing and describing 
the parts more than the knowledge of their uses requires, perplex 
the learners, and make the science tedious, dry, and difficult. 

Upon this principle, the following anatomical description of the 
human body is conducted ; and to render it perfectly intelligible to 
the uninformed readers, technical terms have, as much as possible, 
been avoided. 

" When a master builder," says the celebrated Hervey, whose 
sublime sentiments on this theme are at once so elegant and appro- 
priate that I have taken the liberty frequently to use them, " un- 
dertakes to erect a magnificent edifice, he begins with the less deco- 
rated, but more solid parts, those which are to support, or to contain 
the rest." This order we will follow in considering the structure of 
the human frame. 

The Bones are the hardest and most solid parts of the human 
machine, cast into a variety of moulds, enlarged or contracted into 
a variety of sizes, and calculated from their strength, to support the 
whole body. The manner of their articulation is truly admirable, 
and remarkably various ; yet never varied without demonstrating 
some wise design and answering some valuable end. They con- 
tain marrow, which makes them less brittle, and are covered with a 
membrane, or thin substance like a bladder, called periosteum, ex- 
cept on the skull, where it is called pericranium, which is exqui- 
sitely sensible in an inflamed state, being plentifully supplied with 
nerves and blood, vessels. Its use is to sustain the vessels which 
enter the substance of the bones with their nourishment. The Head, 
designed for the residence of the brain, is framed in exact conformity 
to this important purpose, ample to receive it; strong to uphold it; 
and firm to defend it. 

The Ribs, turned into a regular arch, are gently moveable for the 
act of respiration. They form a secure lodgement for the lungs and 
the heart. 

The Back-bone is intended not only to strengthen the body, and 
sustain its most capacious store-rooms ; but also to bring down that 
appendage of the brain, which is usually termed spinal marrow. 

The Arms, pendent on either side, are so exactly proportioned to 
each other, that the equilibrium of the structure may not be discon- 



38 OP THE STRUCTURE OP THE HUMAM MACHINE. 

certed. These being the guards which defend, and the ministers 
which serve the whole body, are fitted for the most diversified and 
extensive operations ; firm with bone, yet not weighty with flesh ; 
and capable of performing, with singular expedition and ease, all 
manner of useful motions. To these are annexed the hands, and 
all terminated by the fingers ; which are not, like the arms, of the 
same length, and of equal bigness, but consisting of various little 
bones and a multitude of muscles, what shape can they not assume ? 
what service can they not perform ? 

The Thighs and Legs are alike substantial and stately columns ; 
articulated in such a manner, that they administer most commodi- 
ously to the act of walking, yet obstruct not the easy posture of 
sitting. The legs swell out, towards the top, with a gentle projec- 
tion; and are wrought off, towards the bottom, with neat diminu- 
tions. Which variation lessens their bulk, and at the same time in- 
creases their beauty. 

The Feet compose the firmest and neatest pedestal ; infinitely be- 
yond all that statuary or architecture can accomplish ; capable of 
altering their form, and extending their size, as different circum- 
stances require. Besides performing the office of a pedestal, they 
contain a set of the neatest springs, which help to place the body in 
a variety of graceful attitudes, and qualify it for a multiplicity of 
advantageous motions. The undermost part of the heel, and the 
extremity of the sole, are shod with a tough, insensible, sinewy sub- 
stance. This we may call a natural sandal. It never wears out, 
never wants repair, and always prevents that undue compression of 
the vessels, which the weight of the body, in walking or standing, 
might otherwise occasion. 

While many animals creep on the ground, while all of them are 
prone in their posture or their aspect, the attitude of man is erect, by 
far the most graceful, with an air of dignity, and bespeaking supe- 
riority; and by far the most commodious, fitting us for the prosecu- 
tion of every grand scheme, and facilitating the success of all our 
extensive designs. It is likewise attended with the greatest safety ; 
being, if not less than any other position exposed to dangers, more 
happily contrived to repel or avoid them. 

The Cartilages approach much to the nature of bones, being 
smooth and elastic. In them there is no sensible cavity to contain 
marrow, nor are they covered with any membrane to render them 
sensible as the bones are. . They serve to make the bones, whose 
extremities they cover, move freely in their joints. They also con- 
tribute, in a great measure, to the formation of several parts, as the 
wind-pipe, nose, ears, and breast. 

The Ligaments are tough, compact substances, more flexible than 
cartilages. They have no conspicuous cavities, neither have they 
any sensibility, lest they should suffer upon the motion of the joint. 
They serve to unite the several limbs, and prevent their parting 
from each other, as happen in dislocations. 



OF THE STRUCTURE OF THE HUMAN MACHINE. 39 

The Muscles are distinct portions of soft, red flesh, with strong 
tendinous heads and tails designed for insertion. They are com- 
posed of the slenderous fibres, yet endued with incredible strength; 
fashioned after a variety of patterns, but all in the highest taste for 
elegance, conveniency and usefulness. These, with their tendons 
annexed, constitute the instruments of motion. The former, con- 
tracting their substance, operate somewhat like the pulley in me- 
chanics. The latter, resembling the cord, are fastened to a bone or 
some portion of flesh; and following the muscular contraction, ac- 
tuate the part into which they are inserted. This, and all their 
functions, they exercise, not like a sluggish beast of burden, but 
quick as lightning. A nerve or more in each muscle sets them at 
work, diffusing the power of sensation through the body, or, return- 
ing upon an impression from without, giving all needful intelligence 
to the soul ; so that flesh and nerves are the principal constituents 
of a muscle. Inwardly they supply the several movements of the 
active machine : outwardly they render its appearance plump, well 
proportioned, and graceful. 

The strength of the muscles is astonishing in all persons, but es- 
pecially in cases of frenzy, and in certain extraordinary characters, 
who, by the use of a few muscles only, will easily raise a weight 
much greater than that of their own bodies. 

The Tendons, although much smaller than the body of the mus- 
cle, are composed of the same number of fibres. They are not ca- 
pable of contraction, but serve like ropes to pull when the fleshy 
fibres act, for the commodiousness and firmness of insertion, and the 
direction of motion. 

The use of the tendons is to avoid a large quantity of flesh near 
the joint, to prevent clumsiness in particular places, and for the bet- 
ter admitting of that friction, which, in less compact parts, would 
have been injurious. 

The Nerves are surprisingly minute, white cords, derived from 
the brain, running to every part of the body. They perform two 
distinct offices ; conveying sensation from all parts of the body to 
the brain, and carrying the commands of the will from that seat to 
all the different parts of the body. Most of the muscles of the body 
producing motion are in the guidance of our will; some of them, 
however, entirely independent of it, as those of the heart and ves- 
sels which carry on the circulation of the blood ; and some are partly 
under the direction of our will, and partly independent of it, as in 
respiration. 

But all the muscles, the involuntary, as well as the voluntary, are 
enabled to act only by their communication with the brain ; for w T hen 
that is cut off by the destruction of the connecting nerve, whatever 
impression is made on the part can no longer be felt; the orders of 
the will to that part can no longer be obeyed, and the part itself can 
no longer move. 

The Arteries are strong elastic tubes, which arise from the heart : 



40 OF THE STRUCTURE OF THE HUMAN MACHINE. 

and thence, striking out, as they go into numberless smaller canals 
or branches, distribute the blood to every part of the body. These 
being wide at their origin, lessening as they branch themselves, 
check the rapid motion of the blood. To sustain this shock, they 
are indued with uncommon strength ; by performing this service 
they oblige the crimson current to pass into the narrowest defiles, 
and distribute itself into all quarters. The biood thrown from the 
heart dilates the arteries, and their own elastic force contracts them ; 
by which means they vibrate, in proper places, very perceivably 
against the finger ; bring advices of the utmost importance to the 
physician ; and very much assist him both in discovering the nature 
of diseases, and prescribing for their cures. The larger arteries, 
wherever the body is formed for bending, are situated on the bend- 
ing side ; lest, being stretched to an improper length by the inflec- 
tion, their dimensions should be lessened, and the circulating fluid 
retarded. They are not, like several of the considerable veins, laid 
so near the surface as to be protrusive of the skin ; but are deposited 
at a proper depth in the flesh. This situation renders them more 
secure from external injuries. 

The Veins are tubes or vessels accompanying the arteries, and are 
appointed to receive the blood from their extremities, and re-convey 
it to the heart. Small at their rise, and enlarging as they advance, 
they are void of any pulsation. In these, the pressure of the cir- 
culating fluid is not near so forcible as in the arteries; for which 
reason their texture is considerably slighter. In many places they 
have valves, because the slow motion of the blood in the veins, and 
their weaker contractile power, unassisted by a force adequate to that 
of the heart, have great need of such an invention to ensure its re- 
turn to the heart. 

The Secretory vessels are minute tubes in the different organs 
serving to separate and strain off the different fluids from the general 
mass of blood. 

The Excretory vessels, tubes also belonging to the different or- 
gans, carry off the humours that are separated. 

The Glands, commonly called Kernels, are small bodies of finely 
interwoven vessels, whose office it is to secrete or separate fluids 
from the blood for particular uses, as spittle in the mouth, bile in the 
liver, milk in the breast, &c. Glands, when obstructed, become 
large and indurated, from which scirrhus and cancers are produced. 

The Membranes are thin tunicles or fine webs like a bladder, ap- 
pointed to enwrap the fleshy parts ; to form a connexion between 
some ; to line the cavities, and make a separation between others. 

The Fibres are simple thread-like bodies, serving to form other 
parts; hence some are very hard, as the bony ones ; and others soft, 
as the fleshy parts. 

The Skin, like a curious surtout, exactly fitted, envelopes the 
whole, formed of the most delicate net- work ; whose meshes are 
minute, and whose threads are multiplied even to a prodigy. — The 



OF THE STRUCTURE OF THE HUMAN MACHINE. 41 

meshes are so minute that nothing discernible to the eye passes 
them; though they discharge every moment myriads of superfluous 
incumbrances from the body. The steam arising from the warm 
business transacted within, is carried off by these real, though im- 
perceptible funnels, which constitutes what we usually call insen- 
sible perspiration. A single grain of sand, according to M. Lewen- 
houk, will cover no less than one hundred and twenty-five thousand 
of these funnels, or what has been prettily styled " cutaneous chim- 
neys" The threads are so multiplied, that the point of the smallest 
needle cannot pierce any single part without causing an uneasy sen- 
sation, and an effusion of blood ; consequently without wounding, 
even by so small a puncture, both a nerve and a blood-vessel. 

The outermost covering of the body is that soft whitish tegument 
which rises in the pustule of a blister, and is called scarf skin. The 
next, or true skin, is that reddish and exquisitely tender part which 
appears when the blister is broken, and the dead skin taken off. 
The first is void of sense, and intended to screen the second, not 
only from the stroke of injuries, but even from the impressions of 
the air, which, mild as it may feel to the sheathed, would be too 
rough and sharp for the naked nerves. 

The natural colour of the cuticle is white. The apparent, black 
or brown colour in the African or Indian, is entirely owing to the 
mucous substance under it. 

The skin unites in itself two very essential functions. It is the 
organ of the sense of the touch, and the channel of perspiration. 
For this purpose innumerable nerves and vessels are dispersed 
throughout the skin, which are in the continual act of feeling, and 
at the same time, of secreting and volatilizing noxious particles. It 
has been proved by accurate experiments, that the healthy individual 
daily and insensibly perspires upwards of three pounds' weight of 
superfluous and impure humours. It may, therefore, be confidently 
asserted, that no part of the body is provided with so many impor- 
tant organs, by which it is connected with almost every operation 
performed in animal life, as the skin. By this organization, we are 
placed in immediate connexion with the surrounding atmosphere, 
which particularly affects us through the skin, and exerls its influ- 
ence on our health. We farther feel, directly through that medium, 
the qualities of the air, heat, cold, pressure, and rarefaction. 

Important as the skin is to external life, it is no less so to the in- 
ternal economy of the body, where it appears to be peculiarly de- 
signed to preserve the grand equilibrium of the different systems, by 
which the human frame is supported in its vital, animal, and sexual 
functions. If any stagnation, accumulation, or irregularity arise in 
the fluids, the skin is the great and ever ready conductor, through 
which the superfluous particles are separated, the noxious volatilized, 
and the fluids, stagnating in their course, effectually attenuated ; a 
canal being at the same time opened for the removal of those hu- 
mours, which, if they could get access to the vital parts, such as the 
6 



42 OF THE STRUCTURE OF THE HUMAN MACHINE. 

heart and brain, would cause inevitable destruction. By the proper 
exercise of this organ, many diseases may be suppressed in their 
early stages ; and those which have already taken place, may be most 
effectually removed. No disease whatever can be healed without 
the co-operation of the skin. The nature and constitution of this 
organ most certainly determine either our hope or apprehension for 
the safety of the patient. In the most dangerous inflammatory dis- 
eases, when the prospect of recovery is gloomy, a beneficial change 
of the skin is the only effort by which nature, almost overcome, re- 
lieves herself, and ejects the poison in a surprising manner, fre- 
quently in the course of one night The greatest art of a physician, 
indeed, consists in the proper management of this extensive organ, 
and in regulating its activity, where occasion requires. To mention 
only one circumstance ; it is well known to those who have expe- 
rienced the beneficial effects of a simple blister, that its stimulus, 
like a charm, has frequently relieved the most excruciating pains 
and spasms in the internal parts. 

When the sensibility of the surface is impaired ; when the my- 
riads of orifices designed for the continual purification of our fluids, 
are obstructed, if not closed ; when the subtle nervous texture is 
nearly deprived of its energy, so that it becomes an impenetrable 
coat of mail, is there any reason to wonder that we are so often 
harassed by a sense of constraint and anxiety, and that the uneasiness, 
in many cases, terminates in gloom and melancholy? Ask the 
hypochondriac, whether a certain degree of the cold, paleness, and 
spasmodic sensation in the skin, does not always precede his most 
violent fits of imbecility; and whether his feelings be not most 
comfortable when the surface of his body is vigorous, warm, and 
perspires freely? In short, the degrees of insensible perspiration are 
to him the surest barometer of his state of mind. If our skin be 
disorganized, the free inlets or outlets of the electric, magnetic, and 
other matters, which affect us at the change of the weather, are 
inactive. — Thus the origin of extreme sensibility, towards the various 
atmospheric revolutions, is no longer a mystery ; for, in a healthy 
surface of the body, no inconvenience will follow from such changes. 
If we farther advert to those acrimonious fluids, which, in conse- 
quence of an imperfect state of perspiration, are retained in the body, 
and which affect the most sensible nerves and membranes, we shall 
the better comprehend how cramps and spasms, the torturing pains 
of the gout and rheumatism, and the great variety of cutaneous 
diseases, have of late become so obstinate and general. The just 
proportion of the fluids, and the circulation of the blood, are also 
determined, in no small degree, by the skin ; so that, if these fluids 
become languid, the whole momentum of the blood is repelled 
towards the interior parts. Thus a continual plethora, or fulness of 
the blood, is occasioned; the head and breast are generally op- 
pressed; and the external parts, especially the lower extremities, feel 
chilly and languid. 



OP THE STRUCTURE OF THE HUMAN MACHINE. 43 

May we not infer from what has been advanced, that the 
use of baths is too much neglected, and ought to be universally- 
introduced ? 

Bathing is considered an excellent remedy for alleviating both 
mental and bodily affections. It is not merely a cleanser of the 
skin, enlivening and rendering it more fit for performing its offices; 
it also refreshes the mind, and spreads over the whole systen a sen- 
sation of ease, activity, and pleasantness. It likewise removes stag- 
nation in the larger, as well as in the smaller vessels, gives a uniform, 
free circulation to the blood, and preserves that wonderful harmony 
in our inferior organs, on the disposition of which our health and 
comfort so much depend. A person fatigued or distressed in body 
and mind, will derive more refreshment from the luxury of a tepid 
bath, and may drown his disquietude in it more effectually, than by 
indulging in copious libations to Bacchus. 

There subsists so intimate a relation between our interior and 
exterior vessels, that almost every error or irregularity in the organs 
within, shows itself first on the surface of the body, particularly on 
the face. How often are we struck with the countenance of a per- 
son who thinks himself in perfect health, but whose illness, the re- 
sult of some morbid cause, concealed in the body, justifies, in a few 
days, the serious apprehensions we entertained at our last interview? 
Nature has wisely ordained, that the first appearance of internal 
irregularities should be indicated by the countenance, but to what 
do we generally apply this index? We refuse to avail ourselves of 
her beneficent intimation ; and the continual use of pernicious sub- 
stances, instead of promoting the object we have in view, ultimately 
tarnishes and impairs that beauty which we meant to adorn and 
preserve. 

The secret venom circling in her veins, 

Works through her skin, and bursts in bloating stains; 

Her cheeks their freshness lose, and wonted grace, 

And an unusual paleness spreads her face. Granville. 

We imagine it in our power to improve the skin, without attending 
to the purity of the fluids, though it is indebted to them for its very 
existence; and yet we should smile at a person, who should attempt 
to cleanse an impure tongue by constantly scraping it, when a disor- 
dered stomach was the real cause of that impurity. 

The Cellular Membrane, so called from its numerous cells, 
adheres very closely to the skin, running between the muscles in 
general, and between their several fibres in particular; and commu- 
nicating with the membrane which lines the inside of the breast 
and belly. All its cells communicate with each other throughout 
the whole body, so that from any one pail the whole may be filled 
with air, as is evident in beasts, from the butchers blowing up their 
lean meat with air when newly killed, and in emphysema, where 
the air from a broken rib, getting into one of the cells, forces its way 



44 OF THE STRUCTURE OF THE HUMAN MACHINE. 

into all the rest, distending the body to a frightful size ; as also, in 
general dropsy, wherein all the cells, filled with water, may, by 
puncture, be emptied in the course of a night In health this mem- 
brane is rilled with an oily substance, giving an agreeable rotundity 
to the limbs. It is also the seat of biles, and contributes to keep the 
inner parts warm and pliant ; and, by filling the interstices of the 
muscles, renders the surface of the body smooth and plump. 

The Head, that majestic dome, being the seat of the brain, in 
which the soul is supposed to reside, resembles the General's tent 
in an army, or the Monarch's in a city. It has a communication 
established with all, even the most remote parts of the system; 
having outlets and avenues, for the ready despatch of couriers to all 
quarters, and for the reception of speed)?- intelligence on every inter- 
esting occasion. It is furnished with lodgements wherein to post 
sentinels of various characters, and appoint to various offices, to 
expedite their operations, whether employed in reconnoitering what 
passes without, or examining what claims admittance within. The 
whole turns upon a curious pivot, most nicely contrived to afford the 
largest and freest circumvolutions. This stately capitol is screened 
from heat, defended from cold, and, at the same time, beautified by 
a copious growth of hair. 

The Great Creator, profusely gracious to mankind, has made 
us an inestimable present of the senses to be the inlets of innu- 
merable pleasures, and the means of administering the most valuable 
comforts. High in the head, bright and conspicuous as a star in the 
brow of evening, is placed the eye. In this elevated situation, like 
a sentinel posted in his watch tower, it commands the most enlarged 
prospect. Consisting only of simple fluids, enclosed in thin tunicles, 
it conveys to our apprehension all the graces of blooming nature, 
and all the glories of the visible heavens. How prodigiously won- 
derful that an image of the highest mountains, and a transcript of 
the most diversified landscapes, shall enter the small circlet of the 
pupil ! How surprisingly artful, that the rays of light, like an in- 
imitable pencil, should paint on the optic nerves, paint in an instant 
of time, paint in the truest colours, and exactest lineaments, every 
species of external objects. 

The Eye is so tender, that a slight accident, scarce perceivable by 
some other parts of the body, proves very injurious to its delicate 
frame. It is guarded, therefore, with the most solicitous care ; with 
a care evidently proportioned to its nice texture; and extensive use- 
fulness. It is entrenched deep in the head, and barricaded on every 
side with a strong fortification of bones. The wisdom and goodness 
of the Creator appear in the astonishing apparatus of muscles with 
which the eye is furnished to produce all the necessary and conve- 
nient motions in the situation where it is placed. The eyebrows 
serve to defend this delicate organ from too strong a light ; and as 
the incursion of the smallest fly would incommode the polished sur- 
face, it is farther defended by two substantial curtains (eyelids) 



OF THE STRUCTURE OF THE HUMAN MACHINE. 45 

hung on a most slender cartilaginous rod, which secure it from float- 
ing dust and from every troublesome annoyance. In sleep, when 
there is no occasion to exercise the sense, but an absolute necessity 
to protect the organ, these curtains spontaneously close, and never 
fail to lie shut. On the inside of these curtains or eyelids, lie glands, 
which secrete a limpid fluid, that lubricates the eyeball, as often as 
we wink, or, as it were, oils its wheels, and fits it for a course of 
unwearied activity. 

The Ear consists of an outward porch and inner chambers, with 
tools of the most admirable contrivance, and finished workmanship. 
The porch is that cartilaginous substance standing somewhat pro- 
minent from the head, covered with a tight expansion of the skin, 
and wrought into irregular bends and hollows; which, like circling 
hills, or surrounding rocky shores, collect the wandering undulations 
of the air, and transmit them with vigorous impulse to the finely 
stretched membrane of the tympanum, or drum of the ear. The 
avenue, or narrow entry, is secured from the insinuating attempts 
of little insects, by a morass of bitter and viscous matter, disgustful 
to their taste and embarrassing to their feet. The hammer and the 
anvil, the stirrup and the drum; the winding labyrinths, and the 
winding galleries ; these and other pieces of mechanism, instrumental 
to the power of hearing, are, beyond description, curious. 

Amazingly nice must be the formation, and inconceivably exact 
the tension of the auditory nerves, since they correspond with the 
smallest tremors of the atmosphere, and easily distinguish their most 
subtile variations. With the gentle gales that fan us, or even with 
ruder blasts that assault us, these delicate strings are but little affected. 
Whereas, they are perfect unisons with those fine, those significant 
agitations of the air, which the acutest is unable to discern. These 
living chords, tuned by the touch of an Almighty hand, and dif- 
fused through the echoing aisles and sonorous cells, receive the im- 
pressions of sound and propagate them to the brain. These give 
existence to the charms of music, and reciprocate the rational enter- 
tainments of discourse. The eye perceives only the objects before 
it ; whereas the ear warns us of transactions above us, behind us, 
all around us. The eye is useless amidst the gloom of night, and 
cannot carry its observation through the bolted door or the closed 
window shutter ; but the ear admits intelligence through the darkest 
medium and the minutest cranny. Hence, when we cannot see a 
friend, because of an interposing partition, yet, by the friendly aid 
of this organ, we can learn that he is in the adjoining room by his 
voice, or that he is near by his steps. The eye is upon duty only 
in our waking hours; but the ear is always expanded, and always 
accessible ; a courier which never tires, a centry ever in his box. To 
secure a resource, in case any misfortune should disable one of the 
hearing or seeing organs, our all gracious Maker, has given us 
duplicates of each. 

As there are tremulous concussions impressed upon the air. 



46 OF THE STRUCTURE OF THE HUMAN MACHINE. 

discernible only by the instruments of hearing; there are also 
odoriferous particles wafted by the same aerial vehicle, which are 
perceivable only by the smell. 

The Nostrils are wide at the bottom, that a large quantity of 
effluvia may enter ; narrow at the top, that when entered, they may 
close their ranks, and act with great vigour. Fine, beyond all 
imagination, are the streams exhaled from fetid or fragrant bodies. 
The very best microscopes, which discover thousands and tens of 
thousands of animalcules in a drop of putrified water, cannot bring 
one individual among all these evanescent legions to our sight. 
They sail in numberless squadrons close to our eyes, close by our 
ears; yet are so amazingly attenuated, that they elude the search 
of both. Nevertheless, so judiciously are the olfactory nets laid, and 
so artfully their meshes seized, that they catch these vanishing fugi- 
tives. They catch the roaming perfumes, which fly off from the 
opening honey-suckle, and take the stationed sweets which hover 
round the expanded rose. They imbibe all the balmy fragrance of 
spring, all the aromatic exhalations of autumn, and enable us to 
banquet even on the invisible dainties of nature. 

Furnished with these several organs, 
***** not a breeze 
Flies o'er the meadows, not a cloud imbibes 
The setting sun's effulgence, not a strain 
From all the tenants of the warbling shade 
Ascends, but whence our senses can partake 
Fresh pleasure. 

Akenside. 

Another capacity for frequent pleasure, our bountiful Creator 
has bestowed in the power of taste ; by means of which the food, 
that supports our body, feasts our palate ; first treats us with a pleas- 
ing regale, then distributes its beneficial recruits. The razor, whetted 
with oil, becomes more exquisitely keen ; so the saliva, flowing 
upon the tongue, and moistening its nerves, quickens them into the 
liveliest acts of sensation. This sense is circumstanced in a man- 
ner peculiarly benign and wise; so as to be a standing, though 
silent plea for temperance. 

The sight, smell, and taste, are not only so many separate sources 
of delight, but a joint security to our health. They are the vigilant 
and accurate inspectors which examine our food, and inquire into 
its properties, pleasant or disagreeable, wholesome or noxious. For 
the discharge of their offices, they are excellently qualified, and 
most commodiously situated ; so that nothing can get admission 
through the mouth, till it has undergone the scrutiny and obtained 
the passport of each. 

To all these, as a most necessary and advantageous supplement, 
is added the sense of feeling ; which renders the assemblage com- 
plete. While other senses have a particular place of residence, this 
is diffused throughout the whole body. In the palms of the hands. 



OF THE STRUCTURE OF THE HUMAN MACHINE. 4 1 

on the tips of the fingers, and, indeed, through all the extreme 
parts of the flesh, it is most quick and lively. — The whole army of 
Xerxes drawn out in battle array, with his millions of supernumerary 
attendants, was but as a few gleaners straggling- in the field, if 
compared, either in number or order, with those nervous detach- 
ments, which pervade the texture of the skin and minister to the act 
of feeling. 

The crowning gift, improving the satisfaction and augmenting 
the beneficial effects of all the senses, is speech. Speech makes me 
a gainer from the eyes and ears of other people ; from the ideas they 
conceive, and the observations they make. And what an admirable 
instrument for articulating the voice, and modifying it into speech 
is the tongue ! The tongue has neither bone nor joint ; yet fashions 
itself, with the utmost volubility, into every shape and every posture, 
to express sentiment, or constitute harmony. This little collection 
of muscular fibres, under the conducting skill of the Creator, is 
the artificer of our words. By this we communicate the secrets of 
the breast, and make our very thoughts audible. By this we instruct 
the ignorant, and comfort the distressed ; we glorify God, and edify 
each other. 

Who would not bless for this the gift of speech, 
And in the tongue's beneficence be rich 1 

But still, what is the mansion of flesh, though so exquisitely 
wrought, compared with the noble and immortal inhabitants, which 
reside within ? 

###### ee jifoat intellectual being, 
Those thoughts, which wander through eternity." 

The mind, or soul, of much higher character than that of the 
perishable frame with which it is connected, has neither nerves, 
nor nervous fluids. These are only its agents, in this its imprisoned 
state. When the " silver cord/ 7 is broken, which connects mind 
and matter together, vitality ceases. The body then, with all its 
artful and numerous vessels, fibres, and nerves, and other exquisite 
machinery, undergoes decomposition, and is turned into its original 
elements; but the immortal soul, having shaken off this coil, is 
destined for a new residence ; to flourish in eternal youth ; to out- 
live the wreck of elements and the crush of worlds. It is imbodied. 
even in its residence in another world. " Thou fool," says the 
philosopher and apostle, " that seed which thou sowest is not quick- 
ened except it die. — And that which thou sowest is not that body 
which shall be, but God giveth it a body as it hath pleased him, 
and to every seed its own body. So, also, is the resurrection of the 
dead. The body is sown in the earth in dishonour, it is raised in 
glory; it is sown in weakness, it is raised in power; it is sown a 
natural body, it is raised a spiritual. — Behold, I show you a mys- 
tery. We shall not all sleep, but we shall all be changed. In a 



48 OF THE STRUCTURE OF THE HUMAN MACHINE. 

moment, in the twinkling of an eye, at the last trump; for the 
trumpet shall sound, and the dead shall be raised incorruptible, and 
we shall be changed. For this corruptible must put on incorruption, 
and this mortal must put on immortality." Man, therefore, is not 
what he will hereafter be. What we discover of him here below, 
is only the gross foldage, in which he crawls upon the earth, and 
which he must shortly cast off. 

The animal body has no other relation than to this earth. The 
spiritual body will have enjoyments which " ear hath not heard, 
nor hath it entered, into the heart of man to conceive" New senses 
will be disclosed, multiplying perfections in an almost infinite degree. 
Man's sphere will be aggrandized, and he will become equal to 
superior intelligences. Revelation informs us it will be so ; and the 
parable of the seed is the most expressive and philosophical emblem 
of this wonderful preordination. 

The senses, as they are brought into subjection to the soul, will 
no longer rule over her. Separated from flesh and blood, there will 
remain in her none of those earthly affections resulting from them. 
Transported into the regions of light, the human understanding will 
present no ideas to the will, but those of the highest good. It will 
then have no other than lawful desires, and God will be their con- 
stant and ultimate end. It will love him from gratitude ; fear him 
from a principle of love ; and adore him as the supremely amiable 
being, the eternal source of life, perfection, and happiness. . 

The Thorax, or breast, is situated between the belly and neck. 
The front part is commonly called the breast ; the posterior part the 
back ; and the lateral parts the right and left sides. 

Before we take notice of the internal parts, it may be proper to 
speak of the mammee or breasts. 

These are two glandular bodies, of a round oval figure, most 
remarkable in women. The period of their growing full in the 
female, is about the age of fourteen or fifteen, and that of their 
decreasing, fifty. The breasts are composed of a vast multitude of 
minute vessels to secrete the milk from the blood. These vessels, 
as they approach the nipple, fall into, and form eight or ten large 
pipes, connected together with admirable skill, that, in case of any 
obstruction or accident in any one or more of them, the milk might 
not be obstructed. 

The swelling of the breasts, during the time of gestation, is owing 
to the consent between them and the womb. 

The cavity of the breast is lined by a fine smooth membrane, 
named pleura, and contains those two grand organs, the heart and 
lungs. 

The Lungs are divided into two larger portions, called lobes ; the 
one on the right, and the other on the left side. 

The vessels which enter the lungs, are the trachea, or wind-pipe, 
by which we draw in the air ; the pulmonary artery, which comes 
from the right ventricle of the heart ; and the pulmonary vein, whose 



ON HYGIEINE. 65 



OF AIR. 



Thou cheerful guardian of the ruling year, 
Whether thou wanton'st on the Western gale, 
Or shak'st the rigid pinions of the North, 
Diffuses life and vigour through the tracts 
Of air, through earth and ocean's deep domain. 

Without thy cheerful active energy 
No rapture swells the breast ; no poet sings ; 
No more the Maids of Helicon delight. 
Come then with me ; O ! goddess heavenly gay ! 
Begin the song ; and let it sweetly flow, 
And let it sweetly teach thy wholesome laws ; 
(i How best the fickle fabric to support 
Of mortal man : in healthy body how 
A healthy mind the longest to maintain." — Armstrong. 

As soon as an infant enters the world, the air rushes into its 
lungs, the circulation of the blood through that organ commences, 
and its life from that moment depends " on the breath that is in its 
nostrils" which is incessantly taken in and thrown out of the 
lungs. While the child remained in the womb, it required no 
external air, because it existed in the blood which was received 
from its mother through the umbilical cord, or navel string. But 
as soon as the infant is born, the air is inhaled, and the circulation 
is determined through the lungs, which ever after continues in that 
ivay ; and hence the necessity of breathing, which can never cease 
but with life. 

Since, then, air is the main instrument of vitality, both to man 
and all creatures, it certainly must be a most pleasing and profitable 
study to acquire correct ideas of this great element. 

By the unlettered part of mankind, the vast atmosphere which 
surrounds our globe, to the depth of two and thirty miles, is sup- 
posed to be one simple, colourless, invisible mass, without any 
essential difference of qualities, and without weight. But it is a 
gross mistake ; for instead of being a simple uniform element, it 
is composed of several parts, some of which are widely different 
from each other. We have, too, numberless proofs of its weight ; 
like other bodies falling to the earth, and becoming more dense 
as it approaches its centre. Every one knows that air on the tops 
of high mountains is much thinner than it is below in the valleys ; 
but the weight of air is susceptible of demonstration by positive 
experiment. 

Having exhausted a thin glass flask, and suspended it at one end 
of a balance, which being nicely counterpoised by weights in the 
other scale; this done, admit the air into the flask; into which it 
will rush with a noise, and though the flask was balanced before, 
it will now, upon admission of the air, preponderate. If the flask 
9 



66 ON HYGIEINE, OR THE ART 

hold a quart, it will be found that the weight of the air it now 
contains is about 17 grains, 'so that a quart, of air weighs about 
1 7 grains. 

We will mention another experiment, easily put into practice. 
Some water being poured into a saucer, burn a bit of paper in a 
teacup, which by rarifying, will exhaust and make a vacuum in 
the cup. Then, while the paper is yet burning, turn it hastily 
down, paper and all into the saucer, and the air without will press 
the water up from the saucer into the cup. The water will stand 
within the cup in a column ; and if the cup were thirty-two feet 
high, and the air within it perfectly exhausted, the water would 
rise to that height in it as we have said before. This satisfactorily 
accounts for the rising of water in pumps, or the standing of the 
quicksilver in the barometer. 

If farther proof be necessary to show the weight of that great 
ocean of air, which constantly surrounds us, let a man take a thick 
glass tube, such as is put over lamps, and place it upright on a table 
having a small hole in it for an air pump. Then let him place his 
hand closely over the top of the tube, while a friend with the pump 
extracts the air, and he will find that as the air on the inside is 
removed, the air on the outside will press his hand down with much 
violence. Nor will he be surprised at this pressure of the air, when 
he comes to learn that a column or pillar of air, of only one inch 
diameter, and thirty-two miles high, which is the depth of the 
atmosphere from its top above the clouds to the ground, weighs 
about fourteen pounds. If the hand of the person, which covers 
the top of the tube measure ten inches square, the pressure on it 
will be about one hundred and forty pounds — sufficient in all con- 
science to crush every bone in his hand. By the same token, a 
square foot of such a column of air would weigh near two thousand 
pounds, and as a common-sized man measures about fourteen square 
feet, it is a fact, as curious as it is awful, that every such person 
bears constantly on his body a weight of fourteen tons, or twenty- 
eight thousand pounds of air. Some persons may doubt this from 
the conclusion that such a weight would crush every man to pieces. 
So it would, if it were to press solely on any particular part. But 
this conclusion instantly falls to the ground, when it is recollected, 
that this pressure of the air is uniform and equal all round him, the 
air pressing as strongly from below as from above ; from one side as 
from another ; thus causing the various pressures most exactly and 
admirably to counterpoise each other ; of this we see a wonderful 
instance in the case of fishes in the ocean. One of these animals, 
at a great depth under water, would be crushed to atoms, if all that 
heavy element pressed only on his back. But the God who made 
him has so kindly attended to his safety, as to cause the water that 
surrounds him from below to press upwards as strongly as that from 
above to press downwards. There is another reason why our bodies 
are not so sensible of the tremendous weight of air, which thirty- 



OF PRESERVING HEALTH. 67 

two miles deep presses on us; it is simply this, all bodies are full 
of air; and the air within pressing against that without, preserves 
even the most delicate bodies uninjured. A bladder, or even a bag 
of oiled paper, if filled with water, remains perfectly unhurt, though 
a hundred fathoms below the surface of the sea ; because the water 
within furnishes a full resistance to the water without. But take 
away this resistance from within, and you will find that the slightest 
pressure will bring the two sides together. 

According to the late discoveries in chemistry, the atmosphere 
consists of three different species of air — namely, pure, respirable, 
or dephlogisticated air; azotic, or phlogisticated air; and fixed, or 
carbonic acid air. 

The proportion of the first, namely, pure or vital air, consists, 
according to the French chemists, who have given it the name of 
Oxygen, of 27 or 28 in the hundred parts ; the second, the Azote 
of the French, of 72 or 73 in the hundred ; and the third, namely, 
the Carbonic acid air, of about one part only in the hundred. 

Oxygen is much better adapted to the respiration of animals than 
common atmospheric air. If two animals be enclosed in vessels, 
one of which contains pure Oxygen and the other common atmos- 
pheric air, in proportions equal to the size of the animals, the former 
in the Oxygen will be found to live six or seven times as long as 
the latter in common air. It is properly this Oxygen which we 
inspire, and which is the grand support of animal life. Persons 
apparently dead, or in a state of suffocation, have been instantly 
restored to life, by its influence ; and from the corresponding testi- 
mony of several respectable physicians, it appears to have been 
employed with advantage in many obstinate diseases. The cele- 
brated Ingenhouz, therefore, gave it the name of vital air. It 
promotes combustion in a very high degree. A candle will burn in 
it from six to seven times longer than in common air, with a much 
greater degree of heat, and a more brilliant flame. Bodies in a 
glowing state are immediately inflamed, when put into Oxygen gas; 
and even metals, which are not very fusible, are melted in it with 
the greatest facility. 

Azote, by others called phlogisticated, mephitic, corrupted, or 
suffocative air, is absolutely unrespirable, and not miscible with 
water. It arises from the change which atmospheric air undergoes 
in every process of combustion, putrefaction, and respiration, whether 
produced by nature or art. 

Azote enters into no combination with water, but may be ren- 
dered less hurtful by shaking it with that fluid. This accounts, in 
some measure, for the salubrity of the sea-air. It greatly promotes 
the growth of plants, and readily accumulates in apartments filled 
with people, or containing articles fresh painted with oil colours, or 
in which strongly fragrant flowers are kept without having any ac- 
cession of fresh air. We should be extremely cautious in entering 
such places, as diseases of the breast and lungs are too frequently 
the consequence of neglect or ignorance. 



68 ON HYGIEINE, OR THE ART 

The Carbonic acid air, or fixed air, is rniscible with water, but 
in its pure state is equally imrespirable as the azote. It derives its 
origin, partly from the vinous fermentation of vegetables and some 
animal substances, and partly from the mild alkaline salts and earths 
combined with acid. Much of this air abounds in mines, where it 
frequently distresses the workmen by its suffocating effect. It is 
also observed in most mineral waters, where a stratum of it some- 
times floats upon the surface of the well. — These waters, as well 
as fermented liquors, which contain a considerable portion of fixed 
air, receive from it that well known pungency so agreeable to the 
palate. Hence, flat and spoiled beer or wine, may be corrected and 
restored to its former briskness, by the addition of fixed air evolved 
from chalk and vitriolic acid ; or by mixing it with new beer, or 
wine in a state of fermentation. 

As this species of air quickly extinguishes fire, animals cannot 
live in it. 

These three aerial bodies, though blended together, arrange them- 
selves, in some degree, according to their specific gravities ; that is, 
the proportion of azotic air, which is the lighter body of the three, 
will be found most in the upper part, the oxygen air in the middle, 
and the fixed air will be found most in the lower part of the apart- 
ment. This occasions a circulation in the air, the rarified air will 
ascend, the fixed air sink, and the colder and purer air rush into the 
apartment through every crevice. To render the circulation of the 
air plain to sense, if the air of a room be heated by a fire, whilst the 
air in the next room is cold, and the door between opened, the hot 
air of one room being rarified, will pass through the upper part of 
the opening of the door into the cold room ; and on the contrary, 
the cold air of the other room being heavier, will pass into the former 
through the lower part of the opening. This may be proved by 
applying a candle at the upper and lower openings between the two 
rooms. The direction of the flame of the candle will point out the 
contrary currents of air. It is for this reason, that when a fire is 
lighted in a chimney, a strong current of air enters the room, which 
may be felt by applying the hand near the key-hole, or other small 
openings, if the door and windows be shut. A fire is said to purify 
a room : but this it does partly by drying the dampness of the room, 
and chiefly by promoting the circulation of the air. The fire does 
not perform such service by purifying the bad air, but by removing 
it, and substituting that which is fresh and wholesome. Hence it 
appears that those persons are mistaken, who are over anxious to 
keep air from the apartments of convalescent persons, studiously 
stopping, by list, linings, and sand bags, all the smallest openings 
that admit fresh air. 

Unless the air were constantly renewed, persons would be exposed 
to the most fatal accidents in large assemblies or crowded rooms. 

A rout was lately given at a celebrated bathing place, or spring. 
The room was small and the company very numerous. They had 



OF PRESERVING HEiLTH. 69 

not been long seated at the card-tables, before a young gentleman 
and lady, both in delicate health, fell into a swoon. The doors and 
, windows were immediately thrown open, to afford fresh air, which 
quickly dissipated the alarm, by reviving the young invalids. A 
physician present telling one of his medical companions how 
severely he himself had suffered from the air of that vile oven, and 
that he had made up his mind to write a bitter phillipic against 
routs, was archly answered by his friend: — " Let them alone, 
doctor, how otherwise should twenty-six physicians subsist in this 
place?' 7 

A farther illustration : — Take a room thirty feet by twenty-five, 
and thirty feet high, capable of containing one hundred persons. 
Now, since each person consumes about five cubic feet of air in an 
hour, that is, deprives such a quantity of air of its oxygen, or vital 
principle, it would follow, that, as such a room could contain only 
twenty-two thousand five hundred cubic feet of air, unless the air 
was constantly renewed, it would be rendered completely mephitic 
or noxious in about four hours and a half, and it is probable that 
the greater part of the company would be seriously incommoded, or 
even perish long before that time. 

The following affecting narrative is a melancholy confirmation of 
this fact. In the summer of 1756, the British settlement of Calcutta, 
of India, was attacked by the natives under the viceroy Rajah 
Doulah, a young man of the most violent passions, and without the 
least sense of honour or humanity. After a most obstinate resis- 
tance, the little garrison surrendered themselves prisoners of war, on 
a solemn promise from the Rajah of the most honourable treatment. 
But no sooner had the monster got them in his power, than, utterly 
regardless of that due to honour, humanity, and a brave enemy, 
he barbarously drove them all into a dark shallow vault under 
ground, called the black hole, only eighteen feet square. The 
number of the unfortunate men, thus cruelly immured, was one 
hundred and forty-six, with their gallant commander, Colonel 
Holwell, the historian of the following tragedy. The humane 
reader may form some idea of one hundred and forty -six poor 
fellows, many of them badly wounded and bleeding, and all worn 
out with the fatigue, and covered with the dust and sweat of a hard 
day's fighting, crammed together, on a hot sultry evening, into a 
small dirty hole, eighteen feet square, with only two little windows, 
and those obstructed by strong iron bars. 

A. profuse sweat quickly broke out on every individual, attended 
with an insatiable thirst, which became the more intolerable as the 
body was drained of its moisture. It was in vain they stripped off 
their clothes, or fanned themselves with their hats. 

A difficulty in breathing was next observed, and every one panted 
for breath. Colonel Holwell, who was placed at one of the windows, 
called to the sergeant of the guard, and after striving to excite his 
compassion by drawing a pathetic picture of their sufferings, 



TO OS HYGIEKXE, OR THE ART 

promised him a thousand rupees in die morning, provided he could 
find means to remove some of his people into another place of 
confinement. The sergeant, allured by the promise of so mighty a 
reward, assured him that he would use his utmost endeavours, and 
retired for that purpose. 

What must have been the impatience, at this time, of these 
unfortunate objects? 

In a few moments the sergeant returned with the woful tidings, 
that the viceroy was asleep, and no man durst disturb his repose ! 
The despair of the prisoners now became outrageous. They en- 
deavoured to force open the door, that they might rush on the swords 
of the monsters, by whom they were surrounded, and who derided 
their sufferings; but all their efforts proved ineffectual. They then 
used execrations and abuse to provoke the guard to fire upon them. 

The captain of the guard was at length moved to compassion. 
He ordered his soldiers to bring some skins containing water, which 
by enraging the appetite, only served to increase the genera] agitation. 
There was no other way of conveying it through the windows, but 
by hats; and this mode proved ineffectual, from the eagerness of the 
wretched prisoners who struggled for it in the fits of delirium. The 
cry of water ! water ! issued from every mouth. The consequence 
of this eagerness was, that very little fell to the lot even of those 
who stood nearest the window ; and the most fortunate, instead of 
finding their thirst assuaged, grew more impatient. 

The confusion soon became general and horrid : all was clamour 
and contest ; those who were at a distance, endeavoured to force 
their passage to the window, and the weak were pressed down to 
the ground, never to rise again. 

Colonel Holwell, observing now his dearest friends in the agonies 
of death, or dead, and inhumanly trampled on by the living, finding 
himself wedged up so closely as to be deprived of all motion, begged 
as the last mark of their regard, that they would for one moment 
remove the pressure ; and allow him to retire from the window, and 
die in quiet. 

Even in such dreadful circumstances, which might be supposed 
to have levelled all distinction, the poor delirious wretches, mani- 
festing a respect to his rank and character, immediately gave way, 
and he forced his passage into the centre of the place, which was 
less crowded, because, by this time, about one-third of the number 
had perished, while the rest still pressed to both windows. He 
retired to a platform at the farther end of the room, and lying down 
upon some of his dead friends, recommended his soul to the mercy 
of its Creator. 

Here his thirst grew insupportable; his difficulty in breathing 
increased and he was seized with a strong palpitation at the heart. 

These violent symptoms, which he could not bear, urged him to 
make another effort. He forced his way back to the window, and 
cried aloud, < c Water ! for God's sake, a little water 7" 



OF PRESERVING HEALTH. 



71 



He had been supposed already dead by his wretched companions, 
but finding him still alive, they exhibited another extraordinary 
proof of regard to his person. " Give him water," they cried ; nor 
would one of them attempt to touch it, until he had drunk. He 
now breathed more freely, and the palpitation ceased ; but finding 
himself still more thirsty after drinking, he abstained from water, 
and moistened his mouth, from time to time, by sucking the perspi- 
ration from his shirt sleeves, which tasted soft, pleasant, and 
refreshing. 

The miserable prisoners now began to perceive that it was air, and 
not water that they wanted. They dropt fast on all sides, and a 
strong steam arose from the bodies of the living and the dead, as 
pungent and volatile as hartshorn. 

Colonel Holwell, being weary of life, retired once more to the 
platform, and stretched himself by the Rev. Mr. Bellamy, who 
together with his son, a young lieutenant, lay dead, locked in each 
other's arms. 

In this situation he was soon deprived of sense, and seemed to all 
appearance dead, when he was removed by his surviving friends to 
one of the windows, where the fresh air brought him back to life. 
The Rajah being at last informed that the greater part of the pris- 
oners were suffocated, inquired if the chief were alive, and being 
answered in the affirmative, sent an order for their release, when no 
more than twenty-three survived, of one hundred and forty-six, who 
entered into the prison. 

How many melancholy instances of a similar kind have occurred 
on board vessels engaged in that most abominable and diabolical 
traffic, the slave trade ! 

My soul is sick with every day's report 

Of wrong and outrage with which earth is filled : 

There is no yielding flesh in man's hard heart, 

It does not feel for man. The nat'ral bond 

Of brotherhood is sever'd, as the flax 

That falleth asunder at the touch of fire. 

He finds his fellow guilty of a skin 

Not coloured like his own ; and having power 

To enforce the wrong, for such a worthy cause, 

Dooms and devotes him as a lawful prey. 

Thus man devotes his brother ; 

And worse than all, and most to be deplored, 

As human nature's broadest, foulest blot, 

Chains him, and tasks him, and exacts his sweat 

With stripes, that mercy with a bleeding heart 

Weeps when she sees inflicted on a beast. 

Then what is man? and what man seeing this, 

And having human feelings, does not blush 

And hang his head, to think himself a man ? 

I would not have a slave to till my ground. 

To carry me, to fan me while I sleep. 

And tremble when I wake, for all the wealth 

That sinews bought and sold have ever earned.— Cowper. 



iA ON HYGIEINE, Oft THE ART 

To mention no other fact, a strong proof of the necessity of the 
frequent renewal of air may be found in the records of the Dublin 
lying-in hospital. 

In this hospital two thousand nine hundred and forty-four infants 
out of seven thousand six hundred and fifty, died in the year 1782, 
within the first fortnight after their birth, which is nearly every third 
child ! They almost all died in convulsions, or what the nurses 
call ninth day jits, because they came on nine days after their birth. 
Many of these children foamed at their mouths, their thumbs drawn 
into the palms of their hands, jaws locked ; and faces swelled and 
blue, as though they were choked. The last circumstance led Dr. 
Clark to conclude that the rooms were too close and crowded. That 
benevolent physician contrived therefore, air-pipes, by which the 
rooms were completely ventilated. The consequence was a pro- 
digious decrease in the mortality. It is almost unnecessary to men- 
tion the frequent and sudden deaths that have taken place from 
entering deep wells, cellars, and other confined places. 

Three poor men at Denton, Maryland, having nearly completed 
a deep well, quitted their work to go home to keep the holy-days. 
However, before they left the well, they covered the mouth of it 
closely. Carbonic acid gas settled at the bottom of it. After some 
time the unlucky well-diggers returned, and, opening the well, very 
unsuspiciously let themselves down to their work. Two out of the 
three perished at the bottom ; the other, not going down, escaped. 

Lime-kilns, throwing off large quantities of fixed air, are extremely 
dangerous. 

Two disorderly young women, after rambling a greater part of the 
night, crept early in the morning, into a little hovel contiguous to 
a lime-kiln, and fell asleep. The kiln being in high blast, diffused 
a portion of vapour through the crevices into the hovel ; but the 
poor wretches were too sound asleep to be awakened. After some 
hours, the man, who had the care of the kiln, coming to look after 
his work, finding these women asleep, endeavoured to awake them, 
but in vain ! They were taken immediately to the hospital. The 
one first conveyed recovered, but the other perished. 

There is another species of mephitic air, which burns with a 
bright flame, and, if mixed with common air, instantly catches fire, 
and explodes; hence it has received the name of " inflammable air." 
Mines and coal-pits are frequently infected with this gas, which, 
being ten times lighter than common air, ascends to the upper region 
of the mine, and is called fire-damp. To discharge this, the miners 
are in the habit of crawling on their hands and feet, and with a taper 
affixed to a long stick, set fire to it, which is succeeded by a terrible, 
and sometimes fatal explosion. This air is often generated in the 
stomach and bowels of animals both living and dead. A lighted 
candle held near, has often caused it to take fire. 

The inflammable vjoman of Coventry, as described by Mr 
Wilmer, appears to have reduced herself by dram drinking, to 



OF PRESERVING HEALTH. 73 

such a state, as to be capable of being set on fire, and burning away 
like a match : so eager, says the learned Dr. Beddoes, were the 
principles of which she was composed to combine with oxygen. 

The Russians and Germans are frequently exposed to fainting 
during their cold season, from the noxious air of their stoves, and 
want of clue ventilation. As soon as a person is discovered in this 
state without sense and motion, he is instantly carried into the open 
air ; and being stript, is rubbed very briskly with snow, or cold water, 
which generally recovers him, if breathing have not been suspended 
above an hour. Faintings, or suffocations from the fumes of char- 
coal, are commonly cured by cold water thrown on the patient. 

As the mass of atmospheric air is incessantly corrupted by the 
respiration of men and animals, by the burning of so many natural 
and artificial fires, by the dissolution and putrefaction of innumerable 
substances, and by various other phlogistic or disoxygenating pro- 
cesses, it would at length become altogether incompetent for its 
original designation, if the all benevolent Creator had not provided 
effectual means for its improvement and renovation. Amongst the 
most powerful of these is the vegetation of plants. For this very 
important discovery, we are indebted to Dr. Priestley, who was so 
fortunate as to make it after he had long employed many fruitless 
attempts to correct impure air by artificial means. He found that 
air rendered deleterious by the breathing of animals, which had died 
in it, was again so completely restored by the vegetation of plants, 
that after the lapse of some days, an animal could live in it with 
equal ease, and for the same length of time, as before. 

The ingenious philosopher, Dr. Ingenhouz, remarked, first, that 
most plants have the property of correcting bad air within a few 
hours, wdien exposed to the light of the sun ; but that, on the con- 
trary, during the night, or in the shade, they corrupt the air: 
secondly, that plants from their own substance afford a very pure 
air, or oxygen, when exposed to the rays of the sun ; but a very 
impure air, or azote, at night, or in the shade : thirdly, that not all 
parts of plants, but only the green stalks of leaves, produce this bene- 
ficial effect : fourthly, that the disengagement of pure or vital air 
does not commence until the sun has been some time above the 
horizon, that it ceases altogether with the termination of daylight; 
and that the disadvantage arising from the impure exhalations of 
plants, during the night, is far exceeded by the great advantage they 
afford during the day; insomuch, that the impure air generated by 
a plant during the whole night, scarcely amounts to a hundredth 
part of the pure vital air, or oxygen, exhaled from the same plant in 
two hours of a serene day. Thus, the atmosphere is constantly 
preserved in that state of purity, which is the most salutary both to 
animals and vegetables. 

As the vegetable kingdom is renewed in spring, and as vegetation 
in general is most lively in that season, there can be little doubt, 
that the pure vital air is then most copiously evolved bv means of 
10 



74 

the light and heat of the sun. Hence it follows that the air of spring 
is more wholesome than that of autumn, which is saturated with 
impure particles. The cold, however, and the frequent winds which 
prevail at a more advanced period, prove extremely efficacious in 
counteracting the baneful effects of corruption and putrefaction. 

All strongly scented bodies are more or less pernicious, not only 
those of a fetid, but even those of a fragrant smell. The latter, if 
too strong, are particularly dangerous, as a sense of disgust does not 
naturally incline us to avoid them. Hence people who carry large 
nosegays in the hot days of summer, or sleep in rooms decorated 
with flowers, are apt to feel themselves affected with headachs : ver- 
tigoes, fainting fits, and even apoplexies, have been produced in 
persons of a plethoric habit. 

The smell of roses, how pleasing soever to most persons, is not 
only odious, but almost deadly to others. 

Warm Air relaxes the body, and occasions a quicker circulation 
of the fluids : hence the tender and infirm suffer severely in hot 
weather; hence arise hysteric and hypochondriac complaints, con- 
vulsions, and diarrhoeas. 

Cold renders bodies more compact, the appetite stronger, and 
digestion easier and quicker. On the contrary, the resistance of the 
fluid parts become so great, that even the increased powers of the 
solids cannot overcome it, if the cold be too violent. In winter the 
blood is much disposed to inflammation; hence stitches in the side, 
inflammatory sore throats, rheumatism, &c. In persons who take 
little exercise, the fluids are apt to stagnate, and the solids to chill 
during the winter. Upon the whole, however, the effects of cold 
weather may be rendered less hurtful, and even salutary to the body, 
if proper exercise be not neglected. 

Damp or Moist Air suddenly relaxes and debilitates, retarding 
the circulation, checking the perspiration, and depressing the spirits. 
If damp air be accompanied with cold, it tends, by obstructing the 
perspiration, to throw the retained humours on the breast, throat, 
stomach, bowels, &c, occasioning sore throats, pleurisies, sick 
stomach, diarrhoeas, &c. If damp air be accompanied with heat, it 
is still worse, by opening the pores, through which the moisture 
penetrates in the body, and predisposes every part of it to putrefac- 
tion and dissolution. This accounts for the great mortality preva- 
lent during the hot season at Batavia, and some of the West India 
Islands. 

Dry and Cool Air, from its elasticity, promotes, in an extraor- 
dinary manner, the serenity and alertness of mind and body ; and 
is, therefore, most agreeable and salubrious, both to the healthy and 
infirm. 

Too sudden a transition from warm to cold air, or the reverse, is 
pernicious. But none have ever complained on leaving, however 
suddenly, the sickly air of the town, for the dry, pure, temperate 
air of the country. After all, the surest sign of good air in any 
place, is the longevity of its inhabitants. 



OF PRESERVING HEALTH. 75 

The most certain marks, by which to distinguish whether the air 
in rooms be damp or not, are the following. The walls or tapestry 
change their colour; bread acquires a mouldy surface ; sponges in 
the rooms retain their moisture ; loaf-sugar turns soft ; iron rusts ; 
brass and copper acquire a green colour, and wooden furniture 
moulders and crumbles to pieces. 

In cities the sitting rooms ought, if possible, to be above the 
ground floor, or on the second story, well ventilated by convenient 
doors and windows. And as to the bed-rooms, they ought assuredly 
to be in the most elevated stories of the house, that they may be as 
far removed as possible from that mass of azote, or deadly air which 
is so copiously generated in large towns, and which naturally settles 
near the ground. 

Dr. Caldwell, lecturing on this subject, states that it was on this 
principle he was induced, contrary to the remonstrances of his family 
and friends, to keep his son in the third story of his house, during 
a very sickly season in Philadelphia, and adds that he could not 
avoid being sensibly struck with its happy effects in preserving his 
health. And I am convinced the excellent health my family en- 
joyed, during eight or nine years' residence in Savannah, was 
greatly owing to sleeping in large well aired chambers, three stories 
from the ground. 

The airing of apartments should not be neglected, even in winter, 
as fires alone are not sufficient to carry off the corrupted air. If 
possible, we should not sit through the day in a room in which we 
have slept ; as the bed clothes, and particularly feather beds, very 
slowly part with the exhalations they have imbibed during the 
night. It farther deserves to be remarked, that all damp vapours 
are prejudicial; hence, keeping wet clothes in dwelling rooms 
should by all means be carefully avoided. 



OF FOOD. 

For this the watchful appetite was given, 
Daily with fresh materials to repair 
This unavoidable expense of life. 
This necessary waste of flesh and blood. 

Hence the concoctive powers, with various art, 
Subdued the cruder aliments to chyle ; 
The chyle to blood : the foamy purple tide 
To liquors, which through finer arteries 
To different parts their winding course pursue ; 
To try new changes, and new forms put on, 
Or for the public, or some private use. — Armstrong. 

Nature not only points out the food fit for infancy, but kindly 
prepares it. When the babe, just born into this cold world, is ap- 
plied to its mother's bosom, it is first agreeably affected by warmth: 



76 



OR THE ART 



next it is delighted with the odour of the milk ; then gratified by the 
flavour of it; afterwards the appetites of hunger and of thirst afford 
pleasure by the possession of their objects, and by the subsequent 
digestion of the aliment; and lastly, the sense of touch is delighted 
by the softness and smoothness of the milky fountain, which the 
innocent embraces with its hands, presses with its lips, and watches 
with its eyes. Satisfied, it smiles at the enjoyment of such a variety 
of pleasures. It feels an animal attraction, which is love ; a gratifi- 
cation when the object is present, a desire when it is absent, which 
constitutes the purest source of human felicity, the cordial drop in 
the otherwise vapid cup of life, overpaying the fond mother for all 
her solicitudes and cares. 

Lo ! at the couch where infant beauty sleeps,, 
Her silent watch the mournful mother keeps ; 
"She,, while the lovely babe unconscious lies,, 
Smiles on her slumb'ring child with pensive eyes., 
And weaves a song of melancholy joy. — Campbell. 

A mother who abandons the fruit of her womb, as soon as it is 
born, to the sole care of a hireling, hardly deserves that tender ap- 
pellation. Nothing can be so preposterous and unnatural, as a 
mother abandoning the care of her child. If we search Nature 
throughout, we cannot find a parallel. Every other animal is the 
nurse of its own offspring, which thrives accordingly. 

Connubial fair ! whom no fond transport warms, 

To lull your infant in maternal arms ; 

Who, blest in vain with tumid bosom, hear 

His tender wailing with unfeeling ear ; 

The soothing kiss, and milky rill deny 

To the sweet pouting lip, and glist'ning eye ! 

Ah ! what avails the cradle's damask roof, 

The eider bolster, and embroider' d woof! 

Oft hears the gilded coach, unpity'd plains ; 

And many a tear the tassell'd cushion stains ! 

No voice so sweet attunes his cares to rest, 

So soft no pillow, as his mother's breast! — Darwin. 

It is in infancy and early age, that the foundation is laid for the 
many diseases arising from indigestion, found in almost every family. 
If children be fed immoderately, the first passages become too much 
distended, and the stomach, by degrees, acquires an unnatural 
craving for food, which must be satisfied, whatever be the conse- 
quence. These excessive supplies are not only unnecessary, but 
produce the most serious and fatal disorders. There is a certain 
relation subsisting between what is taken in, and what is lost by the 
body. If we eat and drink much, we likewise lose much, without 
gaining any more by it than we might do by moderate meals. 
Eating too much retards the growth, and eventually diminishes the 
digestive power of the stomach. Nature is easily satisfied, and is 



OF PRESERVING HEALTH. 77 

always best provided if we do not obtrude upon her more than she 
is accustomed to. If we have, for some time, taken little nourish- 
ment, nature becomes so habituated to it, that we feel indisposed as 
soon as the usual measure is transgressed ; and both the stomach 
and its digestive powers are thereby impaired. 

It would be impossible to lay down fixed rules, whereby to de- 
termine the salubrity or insalubrity of aliments, with respect to the 
individual. 

Experience is, indeed, our chief guide upon this subject ; for, such 
is the peculiarity of constitutions, that the same article which will 
nourish and perfectly agree with one person, would prove highly 
pernicious to another. Let us, therefore, in the selection of our food, 
adopt that which long and careful observation has confirmed to be 
salutary, and avoid those things, however tempting to the palate, 
which we know to be injurious. 

There are, however, articles of diet obviously improper to every 
one ; which, though they may not manifest their ill effects imme- 
diately, yet, nevertheless, undermine and break down by gradual 
operation, the vigour of our systems, and entail upon us, with cer- 
tainty, a train of chronic disorders, of all others the most troublesome 
and difficult to cure. The articles of this description are all high- 
seasoned dishes, and those which are composed of a great variety of 
ingredients. People in health require no excitement to the relish 
of good and wholesome meat ; and to those in the opposite state, 
the luxuries of the table are poison. 

The sad effects of luxury are these : 
We drink our poison and we eat disease. 
Not so, O Temperance bland • when ruled by thee, 
. The brute's obedient, and the man is free : 
Soft are his slumbers, balmy is his rest, 
His veins not boiling from the midnight feast, 
'Tis to thy rules, bright Temperance ! we owe 
All pleasures which from strength and health can flow; 
Vigour of body, purity of mind, 
Unclouded reason, sentiments refined ; 
Unmix'd, untainted joys, without remorse, 
The intemperate sensualist's never-failing curse. — Dodd 

There are three kinds of appetite : first, the natural appetite — 
which is equally stimulated and satisfied with the most simple dish, 
as with the most palatable ; secondly, the artificial appetite, or that 
excited by bitters, spirits, pickles, and other condiments, which 
remain only as long as the operation of these stimulants continues ; 
thirdly, the habitual appetite, or that by which we accustom our- 
selves to take victuals at certain hours, and frequently without any 
appetite. Longing for a particular food is likewise a kind of false 
appetite. 

By the true and healthy appetite, alone, can we ascertain the 
quantity of aliment proper for the individual. If, in that state, we 
no longer relish a common dish, it is a certain evidence of its disa- 



78 

greeing with our digestive organs. If, after dinner, we feel ourselves 
as cheerful as before it, we may be assured that we have taken a 
proper meal; for, if the proper measure be exceeded, torper will 
ensue, with indigestion, and a variety of unpleasant complaints. 

When the tired glutton labours through a treaty 
He finds no relish in the sweetest meat. 
Then hear what blessings Temperance can bring, 
Those blessings, only, form my cause to sing : 
First Health — the stomach cramm'd from every dish, 
A tomb of roast and boii'd, of flesh and fish, 
Where bile and wind, and phlegm and acid jar, 
And all the man is one intestine war, 
Remembers well the school-boy's simple fare, 
The temperate sleeps, and spirits light as air. — Pope. 

A decent, well-furnished and hospitable table, is very commend- 
able in those who can afford it. It speaks the greatness of their 
minds, the goodness of their natures, and gains the blessings of the 
poor and needy, where they are charitably allowed to come in for a 
share; but, when feasting runs into excessive luxury and vain ex- 
pense, it reproaches the author of it with prodigality and folly ; for 
no money can be so truly said to be thrown away, as that which is 
superfluously spent upon the belly. 

It was a maxim of Socrates, " that we ought to eat and drink to 
live, and not to live in order to eat and drink." Temperance is the 
preservation of the dominion of soul over sense, of reason over pas- 
sion. The want of it destroys health, fortune, and conscience. 

Chremes, of Greece, though a young man, was veiy infirm and 
sickly, through a course of luxury and intemperance; and subject 
to those strange sorts of fits which are called trances. In one of 
these, he thought that a philosopher came to sup with him ; who 
out of all the dishes served up at the table, would only eat of one, 
and that the most simple ; yet his conversation was sprightly, his 
knowledge great, his countenance cheerful, and his constitution 
strong. When the philosopher took his leave, he invited Chremes 
to sup with him at a house in the neighbourhood; which also took 
place in his imagination ; and he thought he was received with the 
most polite and affectionate tokens of friendship ; but was greatly 
surprised, when supper came up, to find nothing but milk and 
honey, and a few roots dressed up in the plainest manner, to which 
cheerfulness and good sense were the only sauces. As Chremes 
was unused to this kind of diet, and could not eat, the philosopher 
ordered another table to be spread more to his taste ; and immedi- 
ately there succeeded a banquet composed of the most artificial 
dishes that luxury could invent, with great plenty and variety of the 
richest and most intoxicating wines. — These, two, were accom- 
panied by damsels of the most bewitching beauty. And now 
Chremes gave a loose to all his appetites ; and every thing he tasted 
raised ecstasies bevond what he had ever known. Their charms 



OP PRESERVING HEALTH. 79 

enchanted the enraptured guest, already heated with what he had 
drunk. His senses were lost in ecstatic confusion. Every thing 
around him seemed Elysium, and he was upon the point of 
indulging the most boundless freedom ; when lo ! on a sudden, 
their beauty, which was but a visor, fell off, and discovered to his 
view forms the most hideous and forbidding imaginable. Lust, 
revenge, folly, murder, meagre poverty, and frantic despair, now 
appeared in the most odious shapes, and the place instantly became 
the direct scene of misery and desolation. How often did Chremes 
wish himself far distant from such diabolical company ! and how 
dread the fatal consequences which threatened him on every side ! 
His blood ran chill to his heart ; his knees smote against each other 
with fear ; and joy and rapture were turned into astonishment and 
hoiTor. — When the philosopher perceived that this scene had made 
a sufficient impression on his guest, he thus addressed him : 
" Know, Chremes, it is I, Esculapius, who has thus entertained 
you; and what you have here beheld, is the true image of the 
deceitfulness and misery inseparable from luxury and intemperance. 
Would you be happy, be temperate. Temperance is the parent of 
health, virtue, wisdom, plenty, and of every thing that can render 
you happy in this world, or the world to come. It is, indeed, the 
true luxury of life; for without it life cannot be enjoyed." This 
said, he disappeared ; and Chremes awaking, and instructed by the 
vision, altered his course of life, became frugal, temperate, indus- 
trious; and by that means so mended his health and estate, that he 
lived without pain to a very old age ; and was esteemed one of the 
richest, best, and wisest men in Greece. 

Such is the beautiful moral drawn by the pen of elegant and in- 
structive fiction ; with which, if there be any mind so insensible as 
not to be properly affected, let us only turn to that striking reality 
presented to us in the case of Lewis Cornaro. This gentleman was 
a Venetian of noble extraction, and memorable for having lived to 
an extreme old age ; for he was above a hundred years old at the 
time of his death, which happened at Padua, in the year 1565. 
Amongst other little performances, he left behind him a piece en- 
titled, " Of the advantages of a temperate life," of which we will 
here give our readers some account ; not only because it will very 
well illustrate the life and character of the author, but may possibly 
be of use to those who take the summum bo?ium, or chief good of 
life, to consist in good eating. He was moved, it seems, to compose 
this little piece at the request, and for the benefit of some ingenuous 
young men, for whom he had a regard ; and who, having long since 
lost their parents, and seeing him, then eighty-one years old, in a 
fine florid state of health, were desirous to know of him, what had 
enabled him to preserve, as he did, a sound mind, in a sound body, 
to so extreme an age. He describes to them, therefore, his whole 
manner of living, and the regimen he had always pursued, and was 
then pursuing. He tells them that, when he wfcs young, he was 



SO ON HYGIEINE, OR THE ART 

very intemperate; that his intemperance had brought upon him 
many and grievous disorders ; that from the thirty-fifth to the fortieth 
year of his age, he spent his nights and days in the utmost anxiety 
and pain ; and that, in short, his life was grown a burden to him. 
The physicians, however, as he relates, notwithstanding all the vain 
and fruitless efforts which they had made to restore his health, told 
him that there was one method still remaining which had never 
been tried, but which, if they could but prevail with him to use 
with perseverance, might free him, in time, from all his complaints ; 
and that was a temperate and regular way of Jiving. They added, 
moreover, that unless he resolved to apply instantly to it, his case 
would soon become desperate, and there would be no hopes at all 
of his recovery. Upon this, he immediately prepared himself for 
his new regimen ; and now began to eat and drink nothing but 
what was proper for one in his weak habit of body : but this was, at 
first, very disagreeable to him. He often wanted to live again in 
his old manner , and did, indeed, indulge himself in a freedom of 
diet sometimes, without the knowledge of his physician ; but, as he 
informs us, much to his own detriment and uneasiness. Driven, in 
the mean time, by the necessity of the thing, and resolutely exerting 
all the powers of his understanding, he at last grew confirmed in a 
settled and uninterrupted course of temperance ; by virtue of which, 
as he assures us, all his disorders had left him in less than a year : 
and he had been a firm and healthy man, from henceforward, till 
the time in which he wrote his treatise. 

Some sensualists, as it appears, had objected to his abstemious 
manner of living ; and in order to evince the reasonableness of their 
own, had urged that it was not worth while to mortify one's appe- 
tites at such a rate for the sake of being old, since all that was life, 
after the age of sixty-five, could not properly be called a living life, 
but a dead life. " Now," says he, " to show these gentlemen how 
much they are mistaken, I will briefly run over the satisfactions and 
pleasures which I myself enjoy in this eighty- third year of my age. 
In the first place, I am always well, and so active, withal, that I 
can, with ease, mount a horse upon a flat, or walk upon the tops of 
very high mountains. In the next place, I am always cheerful, 
pleasant, perfectly contented, and free from all perturbation, and 
every uneasy thought. I have none of that fastidium vitce, that 
satiety of life, so often to be met with in persons of my age. I take 
a view of of palaces, gardens, antiquities, public buildings, temples, 
fortifications, and endeavour to let nothing escape me which may 
afford the least amusement to a rational mind. Nor are these plea- 
sures at all blunted by the usual imperfections of great age; for I 
enjoy all my senses in perfect vigour; my taste especially, in so high 
a degree, that I have a better relish for the plainest food now, than 
I had for the choicest delicacies formerly, when immersed in a life 
of luxury." 

As a principal rule of diet, we ought to take food with an easy 



OF PRESERVING HEALTH. SI 

and serene mind, and to eat slowly. The stomach suffering in this 
case a very gradual distention, as the food has sufficient time to be 
duly prepared by mastication. To eat of one dish only seems most 
conformable to nature, and is doubtless, the means of procuring the 
most healthy fluids. 

The diet ought not only to be such as is best adapted to the con- 
stitution, but likewise to be taken at regular periods ; for long fast- 
ing is hurtful at any stage of life. All great and sudden changes of 
diet are universally dangerous, particularly from a rich and full diet 
to a low and sparing one. When, therefore, a change becomes ne- 
cessary, it ought always to be made by degrees. 

When a person has suffered so much from extreme hunger, much 
food must not be given at once. By full feeding, thousands long 
starved at sea have been destroyed at once. Such persons should 
be supplied with liquid food, and that sparingly. 

As soon as the food has entered the stomach, the important office 
of digestion begins. The vigour of the organs exerted on this occa- 
sion, ought certainly not to be abridged by violent exercise ; but 
muscular and robust people feel no inconvenience from gentle mo- 
tion about one hour after the heaviest meal. But as the whole pro- 
cess of digestion is of much longer duration than is generally 
imagined, the afternoon hours cannot be employed so advantage- 
ously to health in any labour requiring strong exertions. 

In violent exercise, or an increased state of perspiration, the fluids 
are propelled to the external parts, and withdrawn from the stomach, 
where they are indispensable to assist the proper concoction. 

Exclusive of the quantity and quality of food, great attention is 
due to the kind of it in particular constitutions. Animal food in 
general is more nourishing than vegetable, and, when fresh, is like- 
wise more easy of digestion. On this account, it generally agrees 
best with delicate and weak constitutions. 

But the flesh of young animals, with a proportionate quantity of 
well boiled and wholesome vegetables, is the best diet adapted to 
our system. In summer it is advisable to increase the proportion of 
vegetable food, and to make use of ripe fruit. With regard to our 
food, however, in quantity and quality, it should be proportioned to 
our exercise. The labourer, who is perpetually toiling from morn- 
ing to night, could not subsist on food appropriated to those who 
pursue not the severer exercises of the body. His diet must be of 
the coarser kind; such as salted meats or fish, cheese, com bread, 
potatoes, onions and peas, and these in pretty large quantities. 

On the whole, it will be found to be the safest, both in health and 
sickness, to regulate our diet with simplicity ; ever bearing in mind 
that a preference is to be given to such articles as our personal 
knowledge has demonstrated to be the most congenial to our consti- 
tutions and habits. 

In our aliment, an essential part is drink, the use of which is in- 
dispensable to the digestion of food. 
11 



82 ON HYGIEINE, OR THE ART 

Water, the basis of our drinks, should be carefully obtained in its 
highest purity. The best water is that which is pure, light, and 
without any particular colour, taste, or smell. Where water cannot 
be obtained pure from springs, wells, rivers, or lakes, care should be 
taken to deprive it of its pernicious qualities, by boiling and filtering, 
but most effectually by distillation. Any putrid substances in the 
water may be corrected by the addition of an acid. Thus half an 
ounce of alum, in powder, will make twelve gallons of corrupted 
water pure and transparent in two hours, without imparting a sensi- 
ble degree of astringency. Charcoal powder has also been found of 
great efficacy in checking the putrid tendency of water. To the 
same purpose, vinegar and other strong acids, are well adapted. 

Whatever kind of drink is used, it ought to be taken always in a 
moderate quantity. Too much drink, even of water, innocent as it 
is, tends to oppress and weaken the stomach, of course to generate 
acidities and flatulence. 

Some advise us never to drink without eating something, but he 
who drinks only when nature requires it, has no occasion to eat 
every time he drinks. Persons, on the contrary, once accustomed 
to drink more than is necessary, or to make use of hot, stimulating, 
and intoxicating liquors, would do well always to eat some bread, or 
other solid food, along with them. 

An undue proportion of drink renders the mass of blood too thin 
and watery, and occasions a general debility of the body. On the 
other hand, too little drink renders the blood thick and viscid, and 
weakens the digestive powers. Light and well fermented beer, is a 
wholesome, and, at the same time, diluent species of nourishment. 

Cider, when properly fermented and pure, is also a pleasant and 
wholesome liquor. On the contrary, when it is new or tart, we 
cannot recommend it as a salubrious beverage. 

Wine, when pure, and used in moderation, certainly conduces to 
health, especially in weak and languid habits. See Vine, Mat. Med. 

Ardent Spirits, when properly diluted, are likewise an excellent 
beverage and antiseptic. These liquors are of considerable service 
in preventing the bad effects of a moist and cold atmosphere, pesti- 
lential vapours, damp military camps, unclean occupations, and, 
occasionally too, of a temporary abstinence from food. 

But as the infusion of too great a quantity of oil immediately ex- 
tinguishes the lamp, the light of reason, and the lamp of life itself, 
are frequently suffocated, and put out for ever, by an imprudent use 
of either wine or spirits. 

Tea is considered by some as being highly injurious, while others 
have either asserted its innocence, or even ascribed to it extraordi- 
nary virtues. When taken in a large quantity, or very strong, and 
at a late hour, it often produces watchfulness ; but if used in mode- 
ration, it greatly relieves an oppressed stomach, and pains of the 
head. It ought, however, to be made of a moderate strength, other- 
wise, it certainly affects the nerves. Hypochondriac and hysteric 



OF PRESERVING HEALTH. 83 

people are much deceived in their opinions of the efficacy of tea ; for 
all the evils arising from weak stomachs and flatulency, of which 
they complain, are certainly increased by tea, especially if taken in 
large and strong quantities. The cold stomach which they propose 
to warm by it, is a mere phantom of the brain ; for the sensation of 
cold, is nothing but relaxation, which, instead of being removed by 
hot liquors, is assuredly increased by them. 

Coffee promotes digestion, and exhilarates the animal spirits ; but 
an excessive use of it, like tea, affects the nerves, occasions watch- 
fulness, and trembling of the hands. As possessing excellent anti- 
spasmodic virtues, it is a favourite beverage with the hypochondriac 
and hysteric. 

Chocolate is nutritious and wholesome, if taken in small quantity ; 
but to the corpulent and weak, particularly those with whom a 
vegetable diet disagrees, it is generally hurtful. 



DIGESTION.* 



" The first requisite to digestion is an adequate supply of gastric 
juice, and its thorough admixture with every particle of food on 
which it is to operate. The second is a steady temperature of about 
98° or 100° Fahrenheit. The third is the gentle and continued 
agitation of the alimentary mass in the stomach during the digestive 
process. Much light has been thrown upon the function of diges- 
tion, and consequently upon disorders of this function by the experi- 
ments of Dr. Beaumont on St. Martin, a strong young Canadian, 
who was wounded in the left side, a fistulous opening into the 
stomach remaining without detriment to the general health. For 
some months after the wound the food could be retained only by 
wearing a compress and bandage ; but early in winter, a small fold 
or doubling of the villous coat began to appear, which gradually 
increased till it filled the aperture and acted as a valve, so as com- 
pletely to prevent any efflux from within, but to admit of being 
easily pushed back by the finger from without. Dr. Beaumont 
describes the aperture in St. Martin's stomach as being situated 
about three inches to the left of the cardia, near the left or superior 
termination of the great curvature. When the stomach was nearly 
empty, he was able to examine its cavity to the depth of five or six 
inches by artificial distension. When it was entirely empty, the 
stomach was always contracted on itself, and the valve generally 
forced through the orifice, together with a portion of the mucous 
membrane, equal in bulk to a hen's egg. After sleeping for a few 
hours on the left side, the protruded portion became so much larger, 

# This article on Digestion we copy from the very able work of Dr. Combe, 
of Edinburgh. 



84 ON HYGIEINE, OR THE ART 

as to spread over the neighbouring integuments five or six inches in 
circumference, clearly exhibiting the natural ruga, villous mem- 
brane, and mucous coat, lining the gastric cavity. This appearance 
was almost invariably exhibited in the morning before rising in bed. 

The first point which Dr. Beaumont conclusively settled is, that 
the gastric juice does not continue to be secreted between the inter- 
vals of digestion, and does not accumulate to be ready for acting 
upon the next meal. The next which he established is, that in 
health the gastric secretion always bears a direct relation to the 
quantity of aliment naturally required by the system ; so that if 
more than this be taken, there will be too small a supply of the 
juice for the digestion of the whole. Dr. Beaumont further ascer- 
tained that the gastric secretion and the villous coat, undergo great 
changes during disease. 

In the course of his attendance on St. Martin, he had opportuni- 
ties of seeing, what was actually going on in the organ, and of 
observing, that whenever a feverish state was induced by obstructed 
perspiration, or by stimulating liquors, or by overloading the stomach ; 
and that when influenced by fear, anger, or other emotions, depress- 
ing or disturbing the nervous system, the villous coat became some- 
times red and dry, and at others, pale and moist, having lost its 
smooth and healthy appearance. As a necessary consequence, the 
secretions became vitiated, impaired or suppressed ; and the follicles, 
secreting the mucous which protects the surface of the villous coat, 
became flaccid, and no longer yielded this bland secretion. The 
nervous and vascular papillee thus deprived of their defensive shield 
were then subjected to undue irritation. When these diseased 
appearances were considerable, the system sympathised, and dryness 
of the mouth, thirst, quickened pulse, &c. showed themselves; and 
no gastric juice could be procured or extracted, even on the appli- 
cation of the usual stimulus of food. 

The dry, irritated appearance of the villous coat, and the absence 
of the healthy secretion in the febrile state, not only explain at once 
the want of appetite, nausea and uneasiness generally felt in the 
region of the stomach, but also show the folly of attempting to sus- 
tain strength, by forcing the patient to eat, when the food cannot be 
digested, and when nature instinctively refuses to receive it. The 
inferences drawn from the experiments and observations of Dr. 
Beaumont and others, that more immediately concern the subject 
under consideration, may be stated as follows : — 

1. That the processes of mastication, insalivation and deglutition 
are important, not merely as subjecting the food to the gastric juice, 
in a state of due preparation for its action, but also as allowing time 
for the regular contraction of the stomach upon each individual 
morsel conveyed into it ; as well as transmitting the food in small 
portions at a time, so as to prevent a too rapid, or excessive and 
injurious distention of the organ. 

2. That the gastric juice is the agent of chymification ; that it is 



OF PRESERVING HEALTH. 85 

secreted from vessels distinct from the mucous follicles; that it is a 
clear, transparent fluid, without odour, a little salt, and perceptibly 
.acid ; and that it contains free hydrochloric acid, a little acetic acid, 
and some other active chemical principles. 

3. That this juice is never found free in the stomach, but is 
always excited to discharge itself by food or other irritants; that it is 
seldom obtained pure, but generally mixed with mucous, and some- 
times with saliva ; and that when pure it is capable of being kept 
for months, or even years. 

4. That it is a solvent of food, and alters its properties ; that it 
checks the progress of putrefaction, corrects putrid substances, 
coagulates albumen and milk, and afterwards dissolves the coagula; 
and that it commences its action on food as soon as it comes in 
contact with it. 

5. That it is capable of combining with a certain fixed quantity 
of food ; and when more is presented for its action than it will 
dissolve, indigestion will ensue ; and that its action is facilitated by 
the warmth and motions of the stomach, these motions taking place 
chiefly in two directions, transversely and longitudinally. 

6. That the gastric juice is modified in quantity, and probably 
in its intimate constitution, so as to suit the kind of food ; and hence 
the occurrence of indigestion on sudden alterations of the kinds, 
quality and quantity of foods. 

7. That the action of the stomach and of its fluids is the same 
on all kinds of diet; and that the motions of the stomach produce 
a constant admixture of food and gastric juice, and thereby facilitate 
digestion. 

8. That solid food of a certain texture, is easier of digestion than 
fluid ; that animal and farinaceous aliments are more digestible than 
vegetable ; but that susceptibility of digestion does not depend alto- 
gether upon natural or chemical distinctions. 

9. That digestion is facilitated by minuteness of division and 
tenderness of fibre, and retarded by opposite qualities. 

10. That the ultimate principles of aliment are always the same, 
from whatever food they may be obtained. 

11. That chyme is homogeneous, but variable in its color and 
consistence ; and that, towards the latter stages of chymification, it 
becomes more acid and stimulating, and passes more rapidly from 
the stomach. 

12. That soups and other liquid food do not call into play the 
muscular coat of the stomach; and before the gastric juice can act 
upon them, the fluid part must be absorbed and the mass thickened 
to a proper consistence for undergoing the usual churning motion 
and, consequently, that this kind of food often gives rise to acidity, 
particularly in weak states of the stomach. 

13. That, owing to the adaptation of the gastric juice to the na- 
ture of the food, sudden or extreme changes from one kind of diet 



OO ON HYGIEINE, OR THE ART 

to another is injurious ; for the stomach has not had time to modify 
its secretions sufficiently to meet the altered demand upon its powers. 

14. That water, ardent spirits, and most other fluids, are not 
affected by the gastric juice, but pass from the stomach soon after 
they have been received ; that heating condiments are injurious to 
the healthy stomach ; and that the use of spirits always causes 
disease of this organ, if persevered in. 

15. That bulk as well as nutriment, is necessary to articles of 
diet ; and that digestibility does not depend upon the quantity of 
nutrient principles that aliments contain. 

16. That the quantity of food, generally taken is more than the 
wants of the system require ; and that such excess, if persevered in 
generally produces functional disorder, and consequently, organic 
disease. 

17. That oily food is difficult of digestion, though it contains a 
large proportion of nutrient principles. 

18. That bile is not usually found in the stomach, and is not 
necessary for the digestion of food ; but that when oily food is used, 
it assists digestion. 

19. That gentle exercise facilitates digestion ; and that the acetic, 
citric, and hydrochloric acids promote this process, particularly if 
vegetables and indigestible substances have been taken. 

20. That the time required for the stomachic digestion depends 
upon the quantity and kind of food and upon the state of the 
stomach ; that the time required for the disposal of a moderate meal, 
in a healthy state of the organ, varies from three hours to three 
hours and a half or four hours ; and that in states of indigestion, the 
process is delayed much longer than this, particularly as respects the 
more indigestible substances. 

21. That a diminution of the temperature of the stomach below 
98° impedes digestion : and that the temperature of the organ is not 
necessarily elevated by the process. 

22. That whatever promotes organic nervous power, without ex- 
hausting it, favours digestion, as breathing a dry, pure air, hilarity of 
mind, moderate laughter, &c. 

23. That the organic or ganglial nervous influence is more con- 
cerned in the process of digestion, than the influence conveyed to 
the stomach by the eighth pair of nerves ; and that the circulating, 
absorbing, and especially the secreting functions of the organ are 
under the dominion of the former, whilst the sensibility and muscu- 
lar contractions are directed by the latter." 



OP PRESERVING HEALTH. 87 



OF EXERCISE. 

###### By health the peasant's toil 

Is well repaid, if exercise were pain 

Indeed, and temperance pain. By arts like these 

Laconia nursed of old her hardy sons : 

And Rome's unconquered legions urged their way 

Unhurt, through every toil and every clime. 

Toil and be strong. By toil the flaccid nerves 

Grow firm, and gain a more compacted tone ; 

The greener juices are by toil subdu'd, 

Mellowed, and subtiliz'd ; the vapid old 

Expell'd and all the rancour of the blood. 

Begin with gentle toils, and, as your nerves 

Grow firm, to hardier by just steps aspire. 

The prudent, even in every moderate walk, 

At first but saunter, and by slow degrees, 

Increase their pace. This doctrine of the wise*, 

Well knows the master of the flying steed. — Armstrong. 

It was a common saying among the ancients, that acute diseases 
are from heaven, and chronic from ourselves. To die, says Dr. 
Johnson, is the fate of man; but to die with lingering anguish, is 
generally his own folly. Inactivity never fails to induce a universal 
relaxation of the contractile fibres. When these fibres are relaxed, 
neither the digestion, the circulation, nor the paristaltic motion can 
be duly performed. 

It is absolutely impossible to enjoy health where the perspiration 
also is not duly carried on ; and that can never be the case, where 
exercise is neglected. 

Indolence often originates from a mistaken education, in which 
pleasure or flattery is made the immediate motive of action, and not 
future advantage, or what is termed duty. This observation is of 
great value to those who attend to the education of their own chil- 
dren. I have seen, says Dr. Darwin, one or two young married 
ladies of fortune, who perpetually became uneasy, and believed 
themselves ill, a week after their arrival in the country, and con- 
tinued so uniformly during their stay; yet, on their return to Lon- 
don or Bath, immediately lost all their complaints. I was led to 
ascribe this to their being surrounded in infancy with menial atten- 
dants, who had flattered them into the exertions they then used ; 
and that, in riper years, they became torpid for want of this stimulus, 
and could not amuse themselves by any voluntary employment ; 
requiring, ever after, either to be amused by other people, or to be 
flattered into activity. 

Dr. Johnson says, " Whenever chance brings within my observa- 
tion a knot of young ladies, busy at their needles, I consider myself 
as in the school of virtue ; and though I have no extraordinary skill 
in plain work or embroidery, I look upon their operations with as 



8S ON HYGIEINE, OR THE ART 

much satisfaction as the governess, because I regard them as pro- 
viding a security against the most dangerous ensnarers of the soul, 
by enabling themselves to exclude idleness from their solitary mo- 
ments, and with idleness, its attendant train of passions, fancies, 
chimeras, fears, sorrows, and desires." 

If sedentary employments be intermixed with a due quantity of 
exercise, they will never injure health. 

Weak fibres are the constant companions of inactivity. Nothing 
but daily exercise in the open air can brace and strengthen the 
powers of the stomach, and prevent an endless train of diseases, 
which proceed from a relaxed state of that organ: We seldom hear 
the active and laborious complain of nervous diseases ; which are 
reserved for the sons of idleness. 

###### How happy he whose toil 

Has o'er his languid powerless limbs diffused 

A pleasing lassitude. He not in vain 

Invokes the gentle deity of dreams. 

By toil subdued, the warrior and the hind 

Sleep fast and deep. — Their active functions soon 

With generous streams their subtile tubes supply 

Ere morn, the tonic irritable nerves 

Feel the fresh impulse and awake the soul. — Armstrong. 

Idleness is a servile, weak and degenerate habit; that of the 
mind being worse than that of the body. 

A gentleman states, that, as he was sitting with some friends be- 
fore the door of the Capitol, a beggar presented himself, who with 
sighs, tears, and lamentable gestures, expressed his miserable poverty, 
saying withal, that he " had about him a private disorder, which 
shame prevented him from discovering to the eyes of men. They, 
pitying the case of the poor man, gave each of them something, and 
he departed. One amongst them sent his servant after him, to in- 
quire what his private infirmity might be, which he was loath to 
discover? The servant overtook him ; and desired the satisfaction ; 
and having diligently viewed his face, breast, amis, &c. and finding 
all his limbs in good plight, u I see nothing," said he, " whereof 
you have any such reason to complain." " Alas !" said the beggar, 
" the disease that afflicts me is far different from what you conceive 
of, and is such as you cannot see. It is an evil that has crept over 
my whole body ; passing through the very veins and marrow of me, 
in such a manner, that no one member of my body is able to take 
proper exercise, or do any work. This disease by some is called 
idleness." The servant having left him, returned with this account ; 
which not a little amused his master and friends. 

As idleness is the rust and bane of all human virtues, so, on the 
contrary, industry and diligence in business are conquerors of all 
difficulties ; sweetening labour and pains, and giving satisfaction as 
well as profit, in the accomplishment of what is undertaken. When 



OF PRESERVING HEALTH. 89 

men work at their play, and play with their work, they invert the 
order of nature, as well as the Divine command, and must expect 
in the sequel to come home by Weeping Cross, because they have 
laboured in vain, and played the fool with themselves in neglecting 
to secure to themselves a comfortable subsistence. Among the 
Athenians and ancient Romans, there was a law exacting an ac- 
count from every man how he maintained himself and family ; 
and if unable to give a satisfactory answer, he was immediately 
banished with reproach, as a vermin that devoured what he had no 
right to, in being an unprofitable excrescence, contributing nothing 
towards the tranquillity of the public. 

A gentleman possessed of an estate of about two hundred pounds 
per annum, in land, kept the whole a great while in his own hands; 
but finding, notwithstanding all his care and industry, that he still 
run behind hand, and at length obliged to sell half his estate to pay 
his debts, let the rest to a farmer by lease for twenty-one years, at 
an annual rent. His tenant thriving, and coming before the expi- 
ration of the lease, to pay his rent, he asked his landlord, " if he 
would sell the land he rented of him?" " Why," said he, " wouldst 
thou buy it?" " Yes," said the farmer, " if you will part with it." 
u That is very strange," said the landlord. " Prithee tell me how 
it is, that I could not live upon twice so much being my own, and 
you upon half of it, though you pay rent for it, are able in less than 
twenty years to buy it?" a O sir," said the farmer, " a few words 
make the difference. When any thing was to be done, you said, 
4 Go and do it,' and lay in bed or took your pleasure ; but 1 always 
said, ' Come, let us go and do it,' and both assisted and saw my 
business done myself." 

To show the absolute necessity of exercise in cold climates, we 
cannot omit relating the botanical excursion of Sir Joseph Banks, 
Dr. Solander, and others, on the heights of Terra-del- Fuego. Dr. 
Solander, who had more than once crossed the mountains dividing 
Sweden from Norway, well knowing that extreme cold produced a 
torpor and sleepiness almost irresistible, conjured the company to 
keep always in motion, whatever pain it might cost them, and what- 
ever relief they might be promised by rest. " Whoever sits down" 
said he, " will sleep, and whoever sleeps will wake no more." Thus 
at once admonished and alarmed they set forward, but while they 
were still upon the naked rock, and before they got among the 
bushes, the cold was so intense, as to produce the effects that had 
been most dreaded. Dr. Solander, himself, was the first who found 
the inclination, against which he had warned others, irresistible; 
and insisted upon being suffered to lie down. Sir Joseph Banks 
entreated and remonstrated with him in vain ; down he lay upon 
the ground, though it was covered with snow ; and it was with great 
difficulty that his friends kept him from sleeping. One of his black 
servants also began to linger. Partly by persuasion, and partly by- 
force, the company made them go forward. Soon, however, they both 
I/* 



90 



ON HYGIEINE, OR THE ART 



declared, " they would go no farther." Sir Joseph Banks had recourse 
again to expostulation, but this produced no effect. When the black 
was told that if he did not go on, he would in a short time be frozen 
to death, he answered that he desired nothing so much as to lie 
down and die. The Doctor did not so explicitly renounce his life ; 
saying, he could go on, but that he must first take u some sleep" 
though he had before told the company, that " to sleep was to 
perish." Both in a few minutes fell into a profound sleep. After 
considerable exertions they happily succeeded in waking the Doctor, 
who had almost lost the use of his limbs, and the muscles were so 
shrunk, that his shoes fell from his feet; but every attempt to relieve 
the unfortunate black proved unsuccessful. 

Since we have touched upon the subject of cold, we cannot for- 
bear inserting the observations of the immortal Darwin. 

Animal bodies resist the power of cold probably by their exertions : 
but if these increased exertions be too violent, so as to exhaust the 
power of the brain, the animal will probably sooner perish. Thus 
the moderate quantity of wine or spirit, repeated at proper intervals 
of time, might be of service to those who are long exposed to exces- 
sive cold, both by increasing the action of the capillary vessels, and 
thus producing heat, and, perhaps, by increasing in some degree the 
secretion of sensorial power in the brain. But the contrary must 
happen when taken immediately, and not at due intervals. A well 
attested story was once related to me of two men, who set out on 
foot to travel in the snow, one of whom drank two or three glasses 
of brandy before they began their journey, the other contented him- 
self with his usual diet and potation : the one perished, in spite of 
every assistance his companion could afford him, and the other per- 
formed his journey with safety. In this case the power of the brain 
was exhausted by the unnecessary motions of incipient intoxication 
by the stimulus of the brandy, as well as by the exertions of walk- 
ing, which so weakened the dram-drinker, that the cold soonei 
destroyed him ; not having power to produce sufficient muscular or 
arterial action, and in consequence sufficient heat to supply the great 
expenditure of it. Hence the capillaries or smaller vessels of the 
skin, first ceased to act, and became pale and empty ; next those 
which are immediately associated with them ; as the extremities of 
the pulmonary artery, as happens on going into the cold bath. By 
the continued inaction of these parts of the vascular system, the 
blood becomes accumulated in the internal arteries, and the brain is 
supposed to be affected by its compression; because these patients 
are said to sleep, or to become apoplectic, before they die. 

Travellers, benighted in deep snow, might frequently save them- 
selves by laying down on the dry ground, and suffering themselves 
to be entirely covered with the snow, except a small hole for air. 
The ground being usually at the 40th degree of cold, that is, eight 
degrees above freezing, and the snow in contact with their clothes, 
thawing and contracting into the snow next to it, would form above 



OF PRESERVING HEALTH. 91 

them a close, dry coverlet, that would perfectly exclude the external 
cold, and place them in a situation almost as warm as a bed ! 

My reverend and worthy friend, Dr. Andrew Hunter, of Wash- 
ington, overcome with the fatigues of a long day's march, during 
the revolutionary war, threw himself down with the rest of the army, 
on the cold frozen ground. His only cover was a blanket, and a 
saddle his pillow. Instantly his wearied senses were locked up in 
sleep so sound, that he never felt the cold snow, which presently 
began to fall in heavy flakes upon him. Next morning when he 
awoke, he was astonished at his situation — a heavy fall of snow a 
foot deep had completely covered him, through which the heat of 
his breath, melting the snow as it fell, had formed a nice opening. 
Having raised his head, and seeing his comrades still asleep, he laid 
himself down to enjoy a little longer his singular bed, which he de- 
clared was very pleasant. 

If these facts were more generally known, they might save the 
lives of many valuable citizens. 



OF SLEEP. 

The shades descend, and midnight o'er the world 
Expands her sable wings. Great Nature droops 
Through all her works. Now happy he whose toil 
Has o'er his languid powerless limbs diffused 
A pleasing lassitude : he not in vain 
Invokes the gentle Deity of dreams 
His powers the most voluptuously dissolve 
In soft repose : on him the balmy dews 
Of sleep with double nutriment descend. — Armstrong. 

" Tired Nature's sweet restorer, balmy sleep," cannot be dis- 
pensed with. It introduces a most welcome vacation, both for the 
soul and the body. The exercises of the brain and the labours of 
the hands, are at once discontinued; so that the weary limbs repair 
their exhausted vigour, while the pensive thoughts drop their load 
of sorrows, and the busy ones rest from the fatigue of application. 
Most reviving cordial ! equally beneficial to our animal and intel- 
lectual powers. 

Since sleep is so absolutely necessary, so inestimably valuable, 
observe what a fine apparatus Almighty Goodness has made to 
accommodate us with the balmy blessing. With how kind a pre- 
caution he removes whatever might obstruct its access, or impede 
its influence ! He draws around us the curtain of darkness, which 
inclines to drowsiness, and conceals every object (hat might too 



92 ON HYG1EINE, OR THE ART 

strongly agitate the senses. He conveys peace into our apartments, 
and imposes silence on the whole creation. May we not discern 
in this gracious disposition of things, the tender cares of an affec- 
tionate Mother, who hushes every noise and excludes every dis- 
turbance, where she has laid the child of her love to rest? So, by 
such soothing circumstances, and gentle working opiates, He giveth 
to his beloved, sleep. 

No sooner does the morning dawn, and day-light enter the room, 
than this strange enchantment vanishes. The man awakes, and 
finds himself possessed of all the valuable endowments which for 
several hours were suspended or lost. His sinews are braced, and 
fit for action. His senses are alert and keen. The romantic 
visionary heightens into the master of reason, and the frozen or 
benumbed affections melt into tenderness, and glow with benevolence. 

#*##.###0 sacred rest ! 

Sweet pleasing sleep ! of all the powers the best; 

O peace of mind ! repairer of decay ! 

Whose balms renew the limbs to labours of the day, 

Care shuns thy soft approach, and sullen flies away. — Dryden, 

If sleep do not pay the accustomed visit, the whole frame of man 
will in a short time be thrown into disorder ; his appetite cease, his 
spirits dejected, and his mind, abridged of its slumbering visions, 
begin to adopt waking dreams. It is in vain that all light is 
excluded, all sound removed, and books of entertainment read, the 
restless and busy mind still retains its former activity, and reason, 
that wishes to lay down the reins, in spite of herself, is obliged to 
maintain them. This is strongly instanced by Shakspeare, in the 
soliloquy of King Henry. 

How many thousands of my poorest subjects 

Are at this hour asleep ! Oh ! gentle sleep, 

Nature's soft nurse, how have I frighted thee, 

That thou no more wilt weigh my eye-lids down, 

And steep my senses in forgetfulness ? 

Why, rather, sleep, ly'st thou on smoky cribs, « 

Upon uneasy pallets stretching thee, 

And hush'd with buzzing night-flies to thy slumbers ; 

Than in the perfum'd chambers of the great, 

And lull'd with sounds of sweetest melody ? 

O thou dull god, why ly'st thou with the vile 

In loathsome beds, and leav'st the kingly couch, 

A watch-case or a common larum bell ? 

Wilt thou upon the high and giddy mast 

Seal up the ship-boy's eyes, and rock his brains 

In cradle of the wild imperious surge ; 

And in the visitation of the winds, 

Who take the ruffian billows by the top, 

Curling their monstrous heads, and hanging them 

With deaf'ning clamours in the slippery shrouds, 

That, with the hurley, death itself awakes 1 



OF PRESERVING HEALTH. 93 

Canst thou, O partial sleep ! give thy repose 
To the wet sea-boy in an hour so rude ; 
And in the calmest, and most stillest night, 
With all the appliances and means to boot, 
Deny it to a King? Then, happy low, lie down! 
Uneasy lies the head that wears a crown. 

Excess of sleep is not less prejudicial to health than the want of 
it. The whole body sinking- gradually into a complete state of 
inactivity, the solid parts become relaxed, the blood circulates slowly, 
and remains particularly long in the head ; perspiration is disordered. 
the body increases in fat, and rendered incapable of being the 
medium of mental exertion, the memory is enfeebled, and the 
unhappy sleeper falls into a lethargic state, by which his sensibility 
is, in a great measure, destroyed. 

Sleep, immediately after supper, is apt to occasion the nightmare, 
or a stagnation of the blood, which, by its pressure, produces the 
sensation or idea of this troublesome bed-fellow. It is principally 
the nervous, the debilitated, and those of an impaired digestion, who 
are visited by such terrific dreams. 

The proper duration of sleep, in youth and adults, is usually 
settled at six or seven hours ; in children and the aged, from eight 
to nine hours. The more bodily weakness we feel, the more we 
may indulge in sleep ; provided it be refreshing. If people in a 
state of health be perfectly cheerful in mind and body, when they 
awake, this is the most certain criterion that they have slept suffi- 
ciently. Though weakly persons may have a disposition to sleep 
during the day, they ought not to sleep long, since it tends to 
increase their languor and relaxation. Whether to sleep after dinner 
be advisable, must be decided by a variety of concurrent circum- 
stances ; age, climate, and the like. However, a sleep after dinner 
ought never to exceed a half, or one hour at most ; and it is also 
much better sitting, than lying horizontally; for, in the latter case, 
we are subject to determinations of the blood towards the head, and 
consequently to headach, and risk apoplexy. In the evening we 
should eat light food, and not retire to rest till two or three hour? 
after supper. The mind ought to be serene and cheerful previously 
to going to rest, and we should then avoid gloomy thoughts; so 
that we may as much as possible guard against dreams, which 
always interfere with the refreshing influences of sleep. 

Sleep, accompanied either with talking or walking, called som- 
niloquism and somnambulism, is a transient paroxysm and delirium. 
When they are induced by an increase of stimuli, whether corporeal 
or mental, blood-letting, gentle cathartics, vegetable diet, with 
moderate exercise, are the best remedies ; but when they arise from 
a diminution of customary stimuli, a glass or two of wine, a draught 
of porter, or a dose of laudanum at bed time, and a change of air, 
will generally succeed. 

The Feather-beds, in which we usually sleep, are certainly not 
as healthy as mattresses in summer. 



94 ON HYGIEINE, OR THE ART 

But, as many individuals have not sufficient resolution to use 
these, they ought to be particular in having their feather-beds fre- 
quently shaken and aired. Farther, it is highly improper to sleep 
in beds overloaded with clothes; they heat the blood more than is 
consistent with health, and produce an immoderate and enervating 
perspiration, which still more weakens the organs already relaxed 
hy sleep. The custom of sleeping with the curtains drawn close, is 
pernicious to health, because the copious exhalations, which then 
take place, cannot be properly dissipated, and are consequently 
re-absorbed. It is also very imprudent to cover the head with the 
bed-clothes. The old and abominable custom of w^arming the bed, 
likewise deserves to be condemned ; as it has a direct tendency to 
produce debility. 

A spacious and lofty room should always be chosen, if practicable, 
for a bed-chamber, and attention paid to the admission of fresh air, 
even during the night, in warm weather. Lastly, no candle or fire 
should be kept burning during the night in a bed-room. 



ON EVACUATIONS. 

By subtle fluid's pour'd through subtle tubes 
The natural, vital, functions are performed ; 
By these the stubborn aliments are tamed_, 
The toiling heart distributes life and strength, 
These the still crumbling frame rebuild. — Armstrong. 

The evacuations of the body, from its superfluous, impure, and 
noxious particles, are no less necessary than its nourishment. The 
same power which changes and assimilates our food and drink, like- 
wise affects the due and timely evacuation of the secretions. It is 
an object of the first consequence, that nothing remain in the body 
which ought to be evacuated ; and that nothing be ejected, which 
may be of use to its preservation. How many persons do we find 
who complain of bad health, notwithstanding every attention they 
pay to air, aliment, exercise, and sleep ; while others enjoy a good 
state of health, though totally careless with regard to these particu- 
lars, and all owing to a difference in the state of evacuations. If 
these be disordered, the most rigorous observance of dietetic rules 
is insufficient to ensure our health ; while, on the contrary, most of 
those rules may be neglected, for some time, without any injurious 
consequences, if the evacuations be regular. Nature removes not 
only noxious matter, or such as is in a state of corruption, but like- 
wise the useful fluids, if they become superabundant ; for instance, 
the milk, semen, and blood. In such cases, therefore, these must 
be considered as objects of evacuation, equally natural and salutary. 



OF PRESERVING HEALTH. 95 

Nature expels all crude and acrid substances by those three grand 
emunctories, the kidneys, bowels, and skin ; and accordingly as they 
are disordered, diseases of different degrees of malignity and duration 
will necessarily ensue. Nature also frequently relieves herself by 
more unusual channels ; such are the bleeding of the nose, in ple- 
thoric young men ; the hemorrhoids, with which persons of a middle 
age are sometimes troubled ; the various ulcers common to those 
whose fluids are in an impure state ; the excretions of saliva, and the 
expectoration of others, &c. By a premature suppression of the 
troublesome, but salutary e/Forts of nature, great mischief may be 
produced to the individual. 

Many persons perspire much under the arm-pits ; others in the 
hands or feet; others again are subject to eruptions in the face, or 
different parts of the body : such canals, however, if nature be once 
accustomed to eject by them certain ill humours, cannot be suddenly 
stopped without considerable danger — cleanliness, in the strictest 
sense of the word, is almost the only safe remedy to counteract their 
fatal effects. 



OF THE PASSIONS. 

Passions, like aliments, though born to fight, 
Yet mix'd and soften'd, in his work unite, 
Love, Hope, and Joy, fair Pleasure's smiling train ; 
Hate, Fear, and Grief, the family of Pain; 
These mix'd with art. and in due bounds confin'd, 
Make and maintain the balance of the mind, 
The lights and shades, whose well accorded strife, 
Gives all the strength and colour of our life. — Pope. 

Passions are the active forces of the soul: They are its highest 
powers, brought into movement and exertion. Like wind and fire, 
which are instrumental in carrying on many of the beneficent oper- 
ations of nature, where they rise to undue violence, or deviate from 
their proper course, their path is marked with ruin: so are the 
passions either useful or destructive, according to their direction and 
degree. 

Yes, yes, dear stoic ! hide it as you can 

The sphere of pleasure is the sphere of man : 

This warms our wishes, animates our toil, 

And forms alike a Newton, or a Hoyle j 

Gives all the soul to all the soul regards, 

Whether she deals in planets, or in cards. — Cawthorn. 



96 



OF LOVE. 

Love is a passion by no rule confin'd, 

The great first mover of the human mind, 

Spring of our fate ! it lifts the climbing will, 

Or sinks the soften'd soul in seas of ill ; 

Science, truth, virtue, sweetness, glory, grace, 

All are love's influence, and adorn his race, 

Love, too, gives fear, despair, grief, anger, strife, 

And all the unnumber'd woes which tempest life. — Hill. 

Love, the most universal and grateful passion of the heart, is not 
only conducive to health, but contributes greatly to the happiness 
of every society in which it is introduced. A warm and reciprocal 
affection, between two virtuous lovers, may be considered the 
sweetest charm of life. 

Where friendship full exerts her softest power, 

Perfect esteem enlivened by desire, 

Ineffable, and sympathy of soul ; 

Thought meeting thought, and will preventing will, 

With boundless confidence : for naught but love 

Can answer love, and render bliss secure. 

* # # # What is the world to them, 

Its pomp, its pleasure, and its nonsense all ! 

Something than beauty dearer, should they look 

Or on the mind, or mind-illumin'd face; 

Truth, goodness, honour, harmony, and love, 

The richest bounty of indulgent Heaven, 

Mean time a smiling offspring rises round, 

And mingles both their graces. By degrees, 

The human blossom blows ; and every day, 

Soft as it rolls along, shows some new charm, 

The father's lustre, and the mother's bloom. — Thomson. 

Love arises from a desire of what is beautiful and fair, and is 
denned to be an action of the mind, desiring that which is good. 
No one loves before he is delighted with the object, let it be what it 
will, by which means it becomes pleasing in our eyes, and begets a 
value and esteem in our affections. This amiable passion in many 
respects is very wonderful and unaccountable ; it is of such power 
in its operation that it has often taken the diadem from kings and 
queens, and made them stoop to those of obscure birth and mean 
fortune. It wrests the sword out of the conqueror's hand, and 
makes him a captive to his slave. It has such a variety of snares to 
entangle the most wary, that few have at one time or other escaped 
them. 

Eginardus was secretary of state to Charlemagne, and having 
placed his affections much higher than his condition admitted, made 
love to one of his daughters, who seeing this man of a brave spirit, 
and a suitable grace, thought him not too low for her, seeing merit 



OF PRESERVING HEALTH. 97 

had so eminently raised him above his birth. She loved him, and 
gave him free access, so far as to suffer him to laugh and sport in 
her chamber on evenings, which ought to have been kept as a sanc- 
tuary where relics are preserved. It happened on a winter's night, 
Eginardus, ever hasty in his approaches, but negligent about return- 
ing, had somewhat too long continued his visit; and in the mean 
time a snow had fallen, which troubled them both. He feared to 
be betrayed by his feet, and the lady was unwilling that such prints 
should be found at her door. Being much perplexed, she did an 
act for her lover, very unusual for the daughter of one of the greatest 
men upon earth. She took the gentleman upon her shoulders, and 
carried him all the length of the court to his chamber, he never 
setting a foot to the ground, so that the next day no impression might 
be seen of his footing. It happened that Charlemagne watched at 
his study this night, and hearing a noise, opened the window and 
perceived this pretty prank, at which he could not tell whether it 
were best to be angry or to laugh. The next day in a great assem- 
bly of lords, and in the presence of his daughter and Eginardus, he 
asked what punishment that servant was worthy of, who made use 
of a king's daughter as a mule, and caused himself to be carried on 
her shoulders in the midst of winter, through night, snow, and all 
the sharpness of the season. Every one gave his opinion, and not 
one but condemned that insolent man to death. The princess and 
secretary changed colour, thinking nothing remained for them but 
to be flayed alive. But the emperor, looking on his secretary with 
a smooth brow, said, " Eginardus, hadst thou loved the princess my 
daughter, thou oughtest to have come to her father, the disposer of 
her liberty ; thou art worthy of death, but I give thee two lives at 
present ; take thy fair portress in marriage, fear God, and love one 
another." 

Though the female be the weaker sex, yet some have so repaid 
the weakness of their nature by an incredible strength of affection, 
that they have oftentimes performed as great things as we could 
expect from the courage and constancy of the most generous amongst 
men. They have despised death, in whatever shape, and made all 
sorts of difficulties give way before its invincible force, which seemed* 
proud to show itself most strong, in the greatest extremity of their 
husbands. 

Arria, the wife of Oecinna Pectus, understanding that her husband 
was condemned to die, and that he was permitted to choose the 
manner of his death, went to him, and having exhorted him to 
depart this life courageously, and bidding him farewell, gave herself 
a stab into the breast with the knife she had hid for that purpose 
under her clothes ; then drawing the knife out of the wound, and 
reaching it to Psetus, she said, " Vulnus, quod feci, Paste, non dolet, 
sed quod tu facies :" The wound I have made Partus, smarts not ; 
but that only which thou art about to give thyself." Whereupon 
Martial wrote the following epigram : — 



98 ON HYGIEINE, OR THE ART 

When Arria to her husband gave the knife, 
Which made the wound whereby she lost her life, 
" This wound, dear Paetus, grieves me not," quoth she 
>e But that which thou must give thyself grieves me." . 

Happy they ! the happiest of their kind, 
Whom gentler stars unite, and in one fate 
Their hearts, their fortunes, and their beings blend. 
'Tis not the coarser tie of human laws 
Unnat'ral oft, and foreign to the mind, 
That binds their peace, but harmony itself 
Attuning all their passions into Love. — Thomson. 

" It is this, says Lavater, " which has sweetened every bitter of 
my life ; this has alone supported me, when the sorrows of a wounded 
heart wanted vent. When my best endeavours were rejected, when 
the sacred impulse of conscious truth was ridiculed, hissed at and 
despised, the tear of sorrow was ever wiped away by the gentle, 
tender, and affectionate address of a female mind, who has an aspect 
like that of unpractised virginity, which felt, and was enabled to 
efface each emotion, each passion in the most concealed feature of 
her husband's countenance, and by endearing means, without what 
the world would call beauty, always shone forth in countenance 
heavenly as an angel." 

Serene in virgin modesty she shines, 
And unobserv'd the glorious orb declines. 
Oh, blest with temper, whose unclouded ray 
Can make to-morrow cheerful as to day : 
She who ne'er answers till a husband cools, 
Or, if she rules him, never shows she rules ; 
Charms by accepting, by submitting sways, 
Yet has her humour most when she obeys. — Pope. 

How delightful that sentiment, which, even in advanced life, in- 
spires a passion, perhaps, more profound than it excites even in 
youth ; a passion which collects into the soul all that time has robbed 
from the senses, and stripping life, in its last stages, of all gloom, 
unsociability and indifference, secures us the happiness of meeting 
death in those arms which sustained our youth, and entwined us in 
the ardent embraces of love. 

O the sweet powerful influences of love ! It is this that unites the 
interests as well as the hearts of lovers, and gives to each the joys 
and felicities of the other. And it is this which induces the delicate 
lady to forget better days, and to smile in poverty, and toil with the 
husband whom she loves. What charm then under Heaven can 
excel this noble passion ? No pleasures are comparable to those that 
affect the heart, and there are none that affect it with such exquisite 
delight, as loving and being beloved by a worthy object. Ask the 
husband who is blest with an amiable wife, and he will tell you 
that the most delicious feeling his heart ever experienced were those 
of virtuous love. 



OP PRESERVING HEALTH. 99 

Go, gentle gales, and bear my sighs along! 
The bird shall cease to tune their evening song; 
The winds to breathe, the waving woods to move, 
And streams to murmur, ere I cease to love. — Pope. 

Some angry poets spit all their venom against loving husbands ; 
but it in no way depreciates virtue. 

Virtue, the strength and beauty of the soul, 

It pleases and it lasts ; a happiness 

That even above the smiles and frowns of fate 

Exalts great nature's favourite ; — a wealth 

That ne'er encumbers, nor to baser hands 

Can be transferred ; it is the only good 

Man justly boasts of, or can call his own.— Armstrong. 

A Neapolitan, being at work in a field bordering upon the sea- 
side, his wife being some distance from him, was seized by some 
corsairs of Tunis, and carried on board their vessel. Missing his 
wife, and seeing a ship at anchor, he soon conjectured what the 
matter was, and throwing himself into the sea, swam to the ship, 
telling the captain, " He was come to take the same fate with his 
wife ; for though he understood the hardship and misery he must 
undergo in slavery, his love had conquered all difficulties, he neither 
could nor would live but with her." The Turks, admiring the 
man's unaccountable affection, at their return told it to the King 
of Tunis, who pleasing himself with so singular an example of love 
and constancy, gave them both their liberty. 

Bless'd is the maid, and worthy to be blessed, 
Whose soul, entire by him she loves possess'd. 
Feels every vanity in fondness lost ; 
And asks no power but that of pleasing most : 
Hers is the bliss, in just return, to prove 
The honest warmth of undissembled love ; 
For her inconstant man might cease to range, 
And gratitude forbid desire to change. 

Love is a vice only in vicious hearts. Fire, though the purest of 
all substances, will yet emit unwholesome and noxious vapours 
when it is fed by tainted matter ; so love, if it grow in a vicious 
mind, produces nothing but shameful desires and criminal designs, 
and is followed with pain, vexation, and misery. But let it rise in 
an upright heart, and be kindled by an object adorned with virtue ; 
it is safe from censure. 

Love, studious how to please, improves our parts 

With polished manners, and adorned with arts, 

It kindles all the soul with honour's fire ; 

Curbs and restrains extravagant desire, 

And to be chaste and kind does still conspire, 

A just heroic passion, that can find 

No room in any base degenerate mind. — Dryden. 



100 ON HYGIEINE, OR THE ART 

In propitious love the heart beats with joy ; vivacity cheers the 
countenance, the eye is brilliant, society is courted, and all the be- 
nevolent affections are indulged. But disappointed love, on the 
other hand, is extremely detrimental. It depresses the spirits, en- 
feebles digestion, takes away the appetite, banishes sleep, and not 
unfrequently produces insanity. History affords many instances of 
mental derangement from disappointed love. — The following affect- 
ing cases deserve to be mentioned. 

A German lady, of great beauty and accomplishments, having 
married a Hessian officer ordered to America, and not being able 
to acquire any tidings of him in her own countiy, came over to 
England. Here, she could only learn the destiny of her husband 
from those ships which had either transported troops to the continent 
or were bringing back the wounded. Day after day she wandered 
on the beach at Portsmouth, and hour after hour she wearied her 
eyes, bedewed with tears, in the vain expectation of seeing him. 
She was observed at the same spot, ere it was light, and watched 
each motion of the waves until the setting sun. Then her haunted 
imagination presented him mangled with wounds, and the smallest 
gust of wind seemed to threaten her with an eternal separation. 
After eight months spent in this anxious manner, she learned that a 
vessel bringing some wounded Hessian officers had arrived : she 
kept at some distance, for fear of giving too great a shock to her 
husband's feelings, should he be among them. He was landed with 
others : she followed to the tavern. When she entered the room, 
he burst into a flood of tears. A lady was supporting him in her 
arms. What words or painter could represent the tragedy that fol- 
lowed ! He had married in America, and this person was also his 
wife. He entreated for "pardon" was past reproach, for in a few 
minutes after he sunk into the arms of death. The lady, whose 
melancholy history we are recording, rushed from the room, and 
leaving her clothes and money at her lodging, wandered, she knew 
not whither, vowing that she would " never enter house more, or 
trust man." She stopped at last near Bristol, and begged the re- 
freshment of a little milk. There was something so attractive in 
her whole appearance, as soon produced her whatever she requested. 
She was young, and extremely beautiful ; her manners graceful 
and elegant, and her countenance interesting to the last degree. 
She was alone, a stranger, and in extreme distress; she asked only 
for a little milk, but uttered no complaint, and used no art to excite 
compassion. Her dress and accent bore visible marks that she was 
a foreigner of superior birth. All the day she was seen wandering 
in search of a place to lay her wretched head ; she scooped towards 
night a lodging for herself in an old hay-stack. Multitudes soon 
nocked around her, in this new habitation, attracted by the novelty 
of the circumstance, her singular beauty, but, above all, the sudden- 
ness of her arrival. French and Italian were spoken to her, but she 
appeared not to understand these languages; however, when she 



OP PRESERVING HEALTH. 101 

was accosted in German, she evidently appeared confused, the emo- 
tion was too great to be suppressed, she uttered some faint exclama- 
tions in that tongue, and then, as if she had been hurried into an 
imprudence, attempted to appear ignorant of this language also. 
Various conjectures were instantly formed, but what seemed passing 
strange, was, her acceptance of no food, except bread or milk, and 
that only from the hands of females. On the men she looked with 
anger and disdain, but sweetly smiled, as she accepted any present 
from the other sex. The neighbouring ladies remonstrated with her 
on the danger of so exposed a situation, but in vain; for neither 
prayers nor menaces could induce her to sleep in a house. 

Beneath the stack Louisa's dwelling rose, 

Here the fair maniac bore four winter's snows, 

Here long she shiver'd, stiff'ning in the blast, 

And lightnings round her head their horrors cast, 

Dishevell'd, lo! her beauteous tresses fly, 

And the wild glance now fills the staring eye, 

The balls fierce glaring in their orbits move, 

Bright spheres, where beam'd the sparkling fires of love. 

It may gratify the reader to learn, that it has been ascertained 
since her death, that this fair sufferer was the natural daughter of 
the Emperor Francis of Germany 

In W , a small village in Saxony, there lived a poor, but 

honest and upright curate, who for many years had enjoyed without 
alloy, the tranquil pleasure of domestic happiness. He had a wife, 
and an only child, a daughter. Content in the sphere wherein they 
were placed, and unacquainted with the turbulent passions of the 
fashionable world, their days flowed quietly on in a uniform course 
of undisturbed felicity. The mother and daughter took a joint care 
of all the domestic concerns, and strove by every act of attention 
and love, to diminish the burden which the duties of the good old 
man imposed on him. Harriet, this was the name of his daughter, 
was in the strict sense of the word, the child after his own heart. 
He was unhappy if she were absent even for a few hours; she was, 
therefore, his constant attendant. — She was about eighteen years 
old, but had not yet experienced the inquietudes of that passion, 
which often exhibits itself in very early life in the great world ; and 
her principles and mode of thinking were too noble and good to 
inspire her parents with even the slightest apprehensions as to the 
wanderings of her heart. But hear her history. Far different from 
the condition of the Americans, the Saxons are obliged in time of 
peace, to receive the king's cavalry, which are quartered in different 
villages, where it is maintained at the expense of the poor peasantry. 
Most of the soldiers are riotous young men, who, by virtue of their 
profession and uniform, obtain entrance into the houses of all the 
peasantry, and even to the curates, to the great corruption of the 
innocent and virtuous manners of the country people. One of them, 
a handsome, but giddy young man, was quartered at W , where 



102 ON HYGIEINE, OR THE ART 

he soon made the acquaintance of the good old parson. The young- 
soldier had more culture of mind than is usually met with in such a 
class of men. He pleased the curate, who often invited him to the 
parsonage, and listened with pleasure to the histories of his battles 
and warlike achievements. 

The tender-hearted Harriet found great entertainment in the 
company of the young warrior, and, like Othello's mistress, the 
story of his life, the battles, seiges, fortunes that he had passed, the 
hair-breadth ''scapes, the moving accidents by flood and field, won 
her heart. — Love had taken possession of her bosom, before she was 
aware of its approach. She blushed when he took her by the hand, 
and was unhappy when he left her. The soldier could not resist 
the beautiful girl, for his heart was formed for love. They, there- 
fore, soon came to an explanation of their mutual passion, which, 
for the present, they agreed to conceal from their parents, for fear 
that prudential motives would cause them to oppose it. They 
bound themselves to each other, however, by an oath, which, at the 
same time that it showed the strength of their affection, exhibited 
the most romantic turn of mind. They promised to marry, as soon 
as he could attain the rank of sergeant-major, and agreed that the 
one should destroy the other ivho first failed, in the engagement. 
Thus matters stood, when, contrary to the wishes of the lovers, a 
lawyer from a neighbouring town applied to the father of Harriet 
for the hand of his daughter. He was well received, and his views 
promoted by the old people ; but when his intention was declared 
to the unfortunate girl, she fell into the arms of her father, as if 
struck with lightning, and, on her recovery, wept bitterly, entreating 
them not to encourage the addresses of this new lover. Her parents, 
being ignorant of the true cause of her aversion, thought that time 
would soon overcome it, and, therefore, gave their solemn promise 
to the lawyer to second his wishes. Harriet, however, resisted every 
argument, and remained true to her promise ; but her parents, at 
length growing tired of her opposition, determined to employ their 
authority, which at last prevailed. The young soldier soon received 
the intelligence, and instantly formed his desperate resolution, for 
without his lovely Harriet he could not live. A short time before 

the marriage day, a dance was given in W , in honour of the 

pair. To this he resorted, unable any longer to resist the desire of 
seeing once more his beloved. He concealed himself among the 
spectators until he saw her dance; which roused him to a state of 
fury. He ran home, took a pair of loaded pistols, and waited until 
the party broke up. It was a dark night, but he discerned the un- 
happy bride intended, and her bridegroom, walking hand in hand. 
He stepped up to her, and in a low voice, requested that she would 
indulge him with a moment's conversation. She disengaged her 
arm from that of the lawyer, entreated him to walk on, assuring 
him she would immediately return: but, alas! she was to return no 
more ! A pistol was heard, and when her trembling friends reached 



OF PRESERVING HEALTH. 103 

the place, they found her weltering in blood, at the feet of her mur- 
derer. " Now art thou mine," cried the soldier, in tones of horrid 
joy, and fled, but not to escape. He delivered himself to the offi- 
cers of justice, and begged to be instantly executed, which event, 
indeed, soon followed. 

Learn, parents, from this story, the danger of interfering with 
your children's affections in so serious an affair as marriage : for as 
Shakspeare observes : 

Marriage is sure a matter of more worth. 
Than to be subject for attorneyship ; 
For what is wedlock,, forced, but a hell, 
An age of discord and continual strife ? 
Whereas the contrary bringeth forth bliss, 
And is a pattern of celestial peace. 

The most dangerous effect of love is jealousy. It is the most vain, 
idle, foolish, and turbulent disease that ever assaulted and oppressed 
the mind of mankind. Of all the diseases of the mind, it is that 
which most things serve for aliment and fewest for remedy. 

Bonaventur, sitting at a table, and looking earnestly upon a beau- 
tiful woman present, was asked by her husband, why he so gazed ? 
He answered : " That he admired the excellency of the Creator by 
contemplating the beauty of the creature ; and that if mortals were 
so amiable, how lovely should we be at the resurrection." This 
was an example, saith Boschier, that was rather to be admired than 
imitated ; suitable to the golden age, and not this present iron age 
of the world, wherein jealousy may be compared to the Indian 
arrows, so envenomed, that if they prick the skin it is very danger- 
ous; but if they draw blood, it is irrecoverably death: the first mo- 
tions that rise from this root of bitterness have their evil effects; but 
where the disease is improved, it impoisons all our comforts, and 
throws us headlong into the most tragical resolutions. 

The Marquis of Astorgas, of the family of Osorio, indulged him- 
self in an illicit intercourse with a most beautiful young woman. 
His wife on being informed of his intrigue, went immediately to the 
house where her husband's mistress lived, and murdered her in the 
most cruel manner. She tore her heart from her bosom, and took 
it home, ordering it to be hashed and served up to her husband for 
dinner. 

After he had eaten of it, she asked him if it were good ? and, on 
his answering yes, she said, she was not in the least surprised, for it 
was the heart of his mistress, whom he so dearly loved. At the same 
time, she drew from a cupboard the bleeding head of his murdered 
favourite, and rolled it on the table at which this unhappy lover was 
sitting with his friends. 

His wife immediately departed, and took refuge in a convent, 
where she soon afterwards went mad with rage and jealousy. 

Earth has no rage like love to hatred turn'd, 
Nor hell a fury like a woman scorn'd. — Dryden, 



104 ON HTTGIEINE, OR THE ART 

The power of beauty is universally acknowledged, having been 
the object of love and admiration in all times and among all nations. 
But, alas! what is beauty without the graces of virtue ! 

In Italy there grows an herb called the Basilisco ; it is sweet- 
scented enough, but, withal, has this strange property, that being 
laid under a stone in a moist place, in a few days it produces a scor- 
pion. Thus, though the woman, in her first creation, was intended 
as a help for man, the partner of his joys and cares, the sweet per- 
fume and relish of his days throughout his whole pilgrimage : yet 
there are some so far degenerated from their primitive institution, 
though otherwise of exterior beauty and perfection enough, that they 
have proved more intolerable than scorpions, not only tormenting 
the life, but hastening the death of their too indulgent husbands. 

Not thai my verse would blemish all the fair, 

But yet if some be bad, 'tis wisdom to beware ; 

And better shun the bait, than struggle in the snare. — Drtden. 

Joan, grand-child to Robert, king of Naples, succeeded her grand- 
father in the kingdom of Naples, and Sicily ; a woman of beautiful 
person and rare endowments of nature. She was first married to 
her cousin Andrew, a prince of royal extraction and of sweet dispo- 
sition ; but being lasciviously disposed, she grew weary of him, and 
caused him to be strangled in the night, and then threw out his 
corpse into the garden, where it lay some days unburied. It is said 
her husband, on seeing her twisting a thick string of silk and silver, 
asked for what purpose she made it ; she answered, " to hang you 
in!" which he then little believed; the rather, because those who 
intend such mischief use not to speak of it before-hand ; but it seems 
she was as good as her word. 

O fairest of creation ! last and best 
Of all God's works! creature in whom excelled 
Whatever can to sight or thought be formed, 
Holy, divine, good, amiable, or sweet ! 
How art thou lost ! — Milton. 

Love is never more abused than by those men who do not design 
to marry. It will generally be found, that libertines will single out 
from among the herd of females, a raw, innocent, young creature, 
who thinks all the world as sincere as herself, to whom they design 
to make their addresses. They take every opportunity to be in 
their company, and pretend to zeal in love, when it is nothing but 
lust that fires them. 

When men's desires and lusts once sated are, 
For oaths and promises they little care. 

The female, who yields her virtue to the brutal desires of a false 
lover, degrades herself in his estimation by the infidelity she com- 
mits, and the surrender of so precious a jewel inspires a remorse 



OF PRESERVING HEALTH. 105 

and shame, when she ceases to be beloved, that constitutes the 
bitterest wo of life. 

It is surely matter of wonder, that these destroyers of innocence, 
though dead to all the higher sentiments of virtue and honour, are 
not restrained by compassion and humanity. To bring sorrow, 
confusion, and infamy into a family ; to wound the heart of a tender 
parent, and stain the life of a poor deluded young woman, with a 
dishonour which never can be wiped off, are circumstances, one 
would think, sufficient to check the most violent passion, in a heart 
the least susceptible of feeling. 



OF HOPE. 

" Hope springs immortal in the human breast, 
Man never is, but always to be blest. 
O Happiness, our being's end and aim, 
Good, Pleasure, Ease, Content, whate'er thy name : 
That something still, which prompts the eternal sigh, 
For which we bear to live, or dare to die." — Pope. 

Hope is the anticipation of joy, or the presentiment of an 
expected good. It is attended with all the favourable effects of a 
fortunate event, without possessing any of its physical advantages ; 
because the expectation of happiness does not affect us so excessively 
as its enjoyment. Besides, it is not liable to those interruptions, 
from which no human pleasure is exempt ; it is employed principally 
with ideal or imaginary objects, and generally keeps within the 
bounds of moderation ; lastly, the sense of happiness contained in 
hope, far exceeds the satisfaction received from immediate enjoy- 
ment ; consequently, it has a more beneficial influence on health, 
than good fortune realized. Although hope is in itself only ideal, 
and presents its nattering images to the fancy in a borrowed light, 
yet it is, nevertheless, the only genuine source of human happiness. 

With thee, sweet Hope ! resides the heavenly light, 

That pours remotest rapture on the sight : 

Thine is the charm of life's bewilder'd way, 

That call's each slumb'ring passion into play. 

Wak'd by thy touch, I see the sister band, 

On tiptoe watching, start at thy command, 

And fly where'er thy mandate bids them steer, 

To pleasure's path, or Glory's bright career. — Campbell. 

The poet Hesiod tells us, that the miseries and calamities of man- 
kind were included in a great tun ; that Pandora took off the lid of 
it; sent them abroad, and they spread themselves in great quantities 
over all lands and seas ; but at this time, 

Hope only did remain behind, and flew not all abroad. 
But underneath the utmost brim and Ledge it still abode. 

14 



106 ON HYGIEINE, OR THE ART 

And this is that which is our principal antidote, which keeps our 
hearts from bursting under the pressure of evils ; and that flattering 
mirror that gives us a prospect of greater good. Hence some call it 
the manna from Heaven, that comforts us in all extremities ; others 
the pleasant and honest flatterer, that caresses the unhappy with 
expectation of happiness in the bosom of futurity. 

A very notable case of the influence of hope on the human body, 
and its maladies, is recorded in the history of the long siege of 
Breda, in 1625, by a physician, eye-witness of the fact. 

That city, from a long siege, suffered all the miseries that fatigue, 
bad provisions, and distress of mind could bring on its inhabitants. 
Among other misfortunes the scurvy made its appearance, and 
carried off great numbers. This, added to other calamities, induced 
the garrison to incline towards a surrender of the place; when the 
Prince of Orange, anxious to prevent its loss, and unable to relieve 
the garrison, contrived to introduce letters addressed to the men, 
promising them the most speedy assistance. These were accom- 
panied with newly discovered medicines against the scurvy, of a 
most extraordinary price, but still more extraordinary efficacy. To 
each physician were given three small vials, filled with drops of such 
sovereign power, that four drops were sufficient to impart a healing 
virtue to a gallon of liquor. We now, says the physician, who 
was one of the eye-witnesses of this curious, fact, began to display 
our wonder-working balsams. Nor were even the commanders let 
into the secret of the cheat upon the soldiers. Ail who had the 
scurvy crowded around us to take their doses. Cheerfulness again 
appears in every countenance, and the universal faith prevails in 
the sovereign virtues of the remedy. The effect of this delusion 
was truly astonishing. Many who had not moved their limbs for a 
month before, were seen walking the streets erect and perfectly 
cured. Many who declared they had been rendered worse by all 
former remedies, recovered in a few days, to their inexpressible joy, 
and the no less general surprise, by their taking, what we affirm to 
be, their gracious Prince's cure. 

" This curious relation," adds Dr. Lind, " would hardly perhaps 
gain credit, were it not, in every respect, consonant to the most ac- 
curate observations, and best attested description of that disease. It 
is given us by an eye-witness, an author of great candour and vera- 
city, who, as he informs us, wrote down every day the state of his 
patients, and seems more to be surprised with their unexpected re- 
covery, than he probably would have been, had he been acquainted 
with the nature of this surprising malady. An important lesson in 
physic," adds this excellent writer, " is hence to be learned ; the 
wonderful influence of the passions of the mind on the state and 
disorders of the body. This is too often overlooked in the cure of 
disorders, many of which are sometimes attempted by the sole 
mechanical operation of drugs, without calling in to our assistance 
the strong powers of the imagination, or the concurring influences 



OF PRESERVING HEALTH. 107 

of the soul. Hence it is, that the same remedy will not always pro- 
duce the same effect, even in the same person ; aud that common 
remedies often prove wonderfully successful in the hands of men not 
of the faculty, which do not answer the purpose in a timorous and 
distrustful patient." 

Primeval Hope, the Aonian muses say, 

When Man and Nature mourned their first decay, 

When every form of death, and every wo, 

Shot from malignant stars to earth below ; 

When Murder bared her arm, and rampant War 

Yok'd the red dragons of her iron car ; 

When Peace and Mercy banish'd from the plain, 

Sprung on the viewless winds to Heav'n again j 

All, all forsook the friendless guilty mind, 

But hope, the charmer, linger'd still behind. — Campbell. 

A certain Rhodian, for his over freedom in speech, was cast, by a 
tyrant, into a cage, and there kept as a wild beast, to his great pain 
and shame : for his hands were cut off, his nostrils slit, and his face 
deformed by several wounds upon it. In this extremity, he was ad- 
vised, by some of his friends, to shorten his life by a voluntary ab- 
stinence from all food. But he rejected their counsel with great 
indignation ; and told them, u While a man is alive, all things are 
to be hoped for him." 

Cease, every joy, to glimmer on my mind, 

But leave — oh ! leave the light of Hope behind ! 

What though my winged hours of bliss have been, 

Like angel- visits, few and far between ! 

Her musing mood shall every pang appease, 

And charm when pleasures lose the power to please ! — Campbell. 

But hope ill-grounded does often trick and bubble the owner, as 
it did the Spanish woman that, coming with three of her sons a beg- 
ging to a French shoemaker that lived in Spain, he said to her one 
day, " Good woman, I will ease thee of some part of thy charge , 
for if thou leave one of thy sons with me I will breed him up in my 
trade, and make him capable of living like a man, and to be helpful 
to his parents also." " God forbid," said the woman, " that I should 
cast away my child to a stranger, and bring him up to so pitiful a 
mechanic trade as a shoemaker, since I live in hopes that the eldest 
will be Viceroy of Naples, the second of Mexico, and the youngest 
of Sardinia." 

Hope, Fortune's cheating lottery ! 

Where, for one prize, a hundred blanks there be. 

Fond archer, Hope ! who tak'st thy aim so far, 

That still, or short or wide, thy arrows are. 

Thin empty cloud ! which th' eye deceives 

With shapes that our own fancy gives : 

A cloud, which gilt and painted now appears, 

But must drop presently in tears. 

Brother of fear ! more gaily clad ! 

The merrier fools o' the two, but quite as mad. — Dryden. 



108 ON HYGIEINE, OR THE ART 



OF JOY. 

Pleasures are ever in our hands or eyes ; 
And when, in act, they ease, in prospect, rise j 
Present to grasp, and future still to find, 
The whole employ of body and of mind. 
All spread their charms, but charms not all alike ; 
On different senses, diff'rent objects strike ; 
Hence different passions, more or less inflame, 
As strong or weak, the organs of the frame ; 
And hence one master passion in the breast, 
Like Aaron's serpent, swallows up the rest. — Pope. 

The consideration of some present good, and which particularly 
belongs to us, begets in the soul that delight which we call joy; for 
as soon as our understanding observes that we are possessed of the 
good we desired, the imagination presently makes some impression 
in the brain, from whence proceeds a motion of the sensitive soul, 
and of the spirits, that excites the passion of joy. By it, the activity 
of the whole machine is enlivened ; the action of the heart and 
arteries is increased ; the circulation of all the fluids is more vigorous 
and uniform, preventing the formation of disease, and facilitating 
the cure of such as are formed. 

There are several degrees of joy, as various circumstances may 
intervene; and so may we distinguish various differences of the 
passion itself; for there is no pleasure or good that may not be 
mixed with some ill or inconvenience. Our extremest pleasure has 
still some air of groaning and complaining in it, unless it be discreetly 
moderated it proves fatal to us when it grows into excess. 

Ptolemeus Philadelphus had received the sacred volumes of the 
law of God, newly brought out of Judea ; and while he held them 
with great reverence in his hands, praising God upon that account, 
all that were present made a joyful exclamation ; and the king him- 
self was so overjoyed, that he broke out into tears. Nature having 
so ordered it, that the expression of sorrow should also be the 
follower of extraordinary joys. 

Askew, a wealthy and facetious farmer of Cornwall, was afflicted 
with a most alarming imposthumation, of which he appeared to be 
on the very point of suffocation. Concluding, from his agonies, that 
he had but a few moments to live, his servants, an ungrateful crew 
to such a generous master, began to plunder. One seized his gold 
watch, another laid violent hands on his plate, and the third, more 
daring still, broke his bureau, and began to finger his gold. A 
monkey, who was present, seeing what they were about, and think- 
ing he might as well take a hand in the game, laid hold of his 
master's wig, and with his gold-headed cane, made him a low bow, 
and began to walk about the room as a man of great consequence. 
The stately steppings and self-assumed dignity of Jacko, so tickled 



OF PRESERVING HEALTH. 109 

the fancy of Mr. Askew, as to excite a most immoderate fit of 
laughter. The imposthumation burst, the purulent matter was 
thrown up — and, to the eternal confusion of his servants, Mr. Askew 
perfectly recovered his health. 

Philemon, a comic poet, beholding an ass eating some figs that a 
boy had laid down; when the boy returned, "Go now," said he, 
" and fetch the ass some drink ;" the old man was so tickled with 
the fancy of his own jest, that he died laughing. In the same 
manner, and much upon the same occasion, died Crysippus. 

Diagoras, the Rhodian, when he saw his three sons all victorious 
in the Olympic games, and crowned the same day, was extremely 
pleased ; but when his sons came and embraced their aged father, 
and each put their triumphal wreath upon his head, he was so over- 
come with joy and delight, that he fell into their arms, and died. 

If we have anticipated any joyful event, the body is gradually 
prepared to undergo the emotions connected with it. For this rea- 
son we ought to fortify ourselves with the necessary share of firm- 
ness, to meet joyful as well as disastrous tidings. 



OF GRIEF. 



It is the great art of life to manage well 

The restless mind. For ever on pursuit 

Of knowledge bent, it starves the grosser powers 

Quite unemployed, against its own repose 

It turns its fatal edge, and sharper pangs 

Than what the body knows, imbitter life. 

Chiefly were solitude, the nurse of care, 

To sickly musing gives the pensive mind, 

There madness enters ; and the dim-eyed fiend, 

Sour melancholy, night and day provokes 

Her own eternal wound. ****** Armstrong. 

Grief, like a poison, corrodes the powers of the mind and body ; 
it enfeebles the whole nervous system ; the heart beats slower ; the 
circulation of the blood, and other fluids, becomes more inert ; the 
appetite and digestion become vitiated, and thus arise obstructions 
and other distressing complaints. Tears are the anodynes of grief, 
and ought, therefore, not to be restrained. They have a tendency 
to prevent the danger to be apprehended from grief, by diminishing 
the spasmodic motions in the breast and head ; and by restoring 
regularity in respiration, as well as in the circulation of the blood. 

A widow lady was left in narrow circumstances with a boy and 
girl, two beautiful and lovely children, the one six, and the other 
seven years of age. As her circumstances allowed her to keep but 
one maid servant, these two children were the sole attention, em 



110 ON HYGIEINE, OR THE ART 

ployment, and consolation of her life. She fed them, dressed them, 
slept with them, and taught them herself. They were both snatched 
from her by the gangrenous sore throat, in one week; so that she 
lost at once all that employed her, as well as all that was dear to 
her. For the first three or four days after their death, when any 
friend visited her, she sat upright with her eyes wide open, without 
shedding tears, and affected to speak of indifferent things. After- 
wards she began to weep much, and for some weeks talked to her 
friends of nothing else but her dear children ; but did not for many 
years, even to her dying hour, get quite over a gloom which was 
left upon her countenance. 

When any cause of deep grief is presented to the mind, it fre- 
quently gains such a force as almost totally to exclude all thoughts, 
except those that are connected with it. Hence the whole imagi- 
nation is, by degrees, obscured, and the most usual consequences of 
it are the deepest melancholy, succeeded by insanity — and some- 
times, that speedier dissolution, " a broken heart." 

When the Turks came to raise the siege of Buda, there was 
amongst the German captains, a nobleman called Rayschachius, 
whose son, a valiant young gentleman, having got out of the army 
without his father's knowledge, he behaved so gallantly in fight 
against the enemy, in the sight of his father and the army, that he 
was highly commended of all men, and especially of his father, who 
did not know he was his son ; yet before he could clear himself, he 
was compassed in by the enemy, and, valiantly fighting, was slain. 
Rayschachius, exceedingly moved by the death of a brave man, 
ignorant how near it touched himself, turning about to the other 
captains, said, " This worthy gentleman, whosoever he be, deserves 
eternal commendation, and to be honourably buried by the whole 
army." As the rest of the captains were, with like compassion, 
approving his speech, the dead body of the unfortunate son was 
presented to the most miserable father, which caused all who were 
present to shed tears ; but such a sudden and inward grief surprised 
the aged father, and struck so to his heart, that, after he had stood 
awhile speechless, with his eyes fixed, he fell down dead. 

The melioration of grief by time, and its being at length even 
attended by pleasure, depends on our retaining any distinct idea of 
the last object, and forgetting for a time, the idea of the loss of it. 
This pleasure of grief is beautifully described by Akenside. 

* * * Ask the faithful youth 

Why the cold urn of her whom long he lov'd 

So often fills his arms : so often draws 

His lonely footsteps at the silent hour 

To pay the mournful tribute of his tears ? 

Oh ! he will tell thee, that the wealth of worlds 

Should ne'er seduce his bosom to forego 

That sacred hour ; when stealing from the noise 

Of care and envy, sweet remembrance sooths 

With virtue's kindest looks, his aching breast, 

And turns his tears to rapture. 



OF PRESERVING HEALTH. Ill 

Whilst the great genius of physic, Hippocrates, drove away mala- 
dies by his precepts, and almost snatched bodies out of the hands 
of death, one Antiphon arose in Greece, who, envious of his glory, 
promised to do upon souls what the other did on bodies ; and pro- 
posed the sublime invention, which Plutarch calls the art of curing 
grief, where we may truly say, he used more vanity, promises, and 
show of words, than he wrought effects. Certainly it were to be 
wished that all ages which are abundant in misery, should likewise 
produce great comforts to soften the calamities of human life. 

O ! canst thou minister to a mind diseased, 
Pluck from the memory a rooted sorrow, 
Rase out the written troubles of the brain ; 
And, with some sweet oblivious antidote, 
Cleanse the stuff 'd mind of that perilous stuff 
Which weighs upon the heart ? — Shakspeare 

In the Pagan religion, the power of dying was the great consola- 
tion in irredeemable distress. Seneca says, " No one need be 
unhappy, unless by his own fault." — And the author of Telemachus 
begins his work by saying, that Calypso could not console herself 
for the loss of Ulysses, and found herself unhappy in being immortal. 
But to the Christian this one suggestion, " I know that my Redeemer 
liveth," affords a richer cordial to the fainting soul, than all the 
volumes of heathen philosophy. 

Many are the sayings of the wise 

In ancient and in modern books enrolPd, 

Extolling patience as the truest fortitude : 

And to the bearing well of all calamities, 

All chances incident to man's frail life. 

Many are the consolatory writs form'd 

With studied argument and persuasion ; 

But with th' afflicted in his pangs such sounds 

Little prevail, or rather seem a tune 

Harsh, and of dissonant mood from his complaint : 

Unless he feel within 

Some source of consolation from above, 

Secret refreshings that repair his strength, 

And fainting spirits uphold. — Milton. 

In the midst of all distresses, there remains to every sincere 
Christian, that mixture of pure and genuine consolation, which 
springs from the promises and hopes of a future life. Consider what 
a singular distinction this makes in your situation, beyond the state 
of those who, under the various troubles of life, are left without 
hope; without anything to look up to, but a train of unknown 
causes and accidents, in which they see no ligbt or comfort. Thank 
the Father of Mercies, that into all the evil he sends, he infuses 
joyful hope, that the sufferings of the present time arc not worthy 
to be compared with the glory that shall be revealed in the end to 
the virtuous and good. Have we sustained the greatest of all losses ? 
It is his gain that he yet liveth, that this life is but the threshold, 



112 ON HYGIEINE, OR THE ART 

the portal, the entrance to a better place, and that his happiness is 
as complete as our miseiy is great. Let us turn our eyes from earth 
to heaven, from the perishable body to that which endureth for ever; 
and even whilst we are heavy with affliction, let us smile with our 
eyes turned upwards, and say, " It is thy will : I submit. He is 
happy. I would not wish him back to a troublesome world. I 
soon shall follow after him. The mortal hath put on immortality — 
We shall then meet, never to be separated more." 

Think, then, ye mourning parents, nor complain 

For breathless children, as ye weep in vain. 

Why should you be in lamentations drown'd, 

While your young babes with victory are crown'd, 

Before the sword was drawn, or cruel strife 

Had shed its venom on the ills of life ? 

Perhaps, Almighty God foresaw some wile, 

Some tempting evil that should them beguile j 

Of sore adversity, a dreadful storm, 

Or of dire wickedness, a monstrous form. 

How then in words which nothing can avail, 

Against that kind precaution dare you rail ? 

Remember that of them you're not bereav'd, 

But from " the coming evil they are sav'd." — Anketell. 



of FEAR. 

Tim'rous self-love, with sick'ning fancy's aid, 

Presents the danger that you dread the most, 

And ever galls you in your tender part. 

Hence, some for love, and some for jealousy, 

Have lost their reason : some for fear of want, 

Want all their lives ; and others every day, 

For fear of dying suffer worse than death. 

Is there an evil worse than fear itself? 

And what avails in that indulgent Heaven 

From mortal eyes has wrapt the woes to come, 

If we, ingenious to torment ourselves. 

Grow pale at hideous fictions of our own? — Armstrong. 

Fear has its origin in the apprehension of danger, and is kindly 
placed in man as a sentinel for self-preservation. But, like every 
other passion, the excess of it is pernicious. 

O Fear ! I know thee by my throbbing heart ; 

Thy withering power inspired each mournful line : 

Though gentle Pity claim her mingled part, 

Yet all the thunders of the scene are thine. — Collins. 

Don Diego Osorius, a Spaniard of a noble family, being in love 
with a young lady of the court, had prevailed with her for a private 
conference under the shady boughs of a tree, that grew within the 
gardens of the king of Spain : but, by the unfortunate barking of a 



OF PRESERVING HEALTH. 113 

little dog, their privacy was betrayed, and the young gentleman 
seized by some of the king's guard, was imprisoned. It was a 
capital crime to be found in that place, and, therefore, he was con- 
demned to die. He was so terrified at the hearing of his sentence, 
that one and the same night saw the same person young, and all 
turned gray as in age. The jailer, moved at the sight, related the 
accident to King Ferdinand, as a prodigy; who, thereupon, par- 
doned him ; saying, " He had been sufficiently punished for his 
fault, seeing he had exchanged the flower of his youth into the 
hoary hairs of age." 

" I knew a surgeon," says Dr. Darwin, "who was always rather of 
a parsimonious disposition, had a large house, with a fortune of forty 
thousand pounds left him ; and in a few weeks became insane from 
the fear of poverty ; lamenting that he would die in a jail or a work- 
house. He had left off a laborious country practice and the daily 
perception of profit in his books : he also now saw greater expenses 
going on in his new house than he had been accustomed to observe, 
and did not so distinctly see the source of supply ; which seems to 
have occasioned the maniacal hallucination. The fear of hell," 
continues he, " has also, in some instances, been attended with fatal 
effects. In this kind of madness, the poor patients frequently com- 
mit suicide ; although they believe they run headlong into the very 
hell which they dread !" 

It is said of Epicurus, a profane teacher, that never was a school 
boy more afraid of a rod, than he was of the thoughts of God and 
death. No man more feared the things which he taught should be 
despised, than himself. For whatever there is in the air, there is 
certainly an elastical power in the conscience, that will bear itself 
up, notwithstanding all the weight that is laid upon it. 

Conscience, the torturer of the soul, unseen, 

Does fiercely brandish a sharp scourge within. 

Severe deerees may keep our tongues in awe, 

But to our thoughts what edict can give law? 

Even you, yourself, to your own breast shall tell 

Your crimes, and your own conscience be your hell.— Dryden. 

The wretched state of Richard the Third, after he had murdered 
his nephew, is thus described by Sir Thomas More : " I have heard," 
saith he, " by credible reports, that after this abominable deed he 
never had quiet in his mind, and never thought himself safe. When 
he went abroad his eyes whirled about, his body was privily fenced, 
his hand ever on his dagger, his countenance and manner like one 
who was ever ready to strike; he took no rest in the night, lay long 
waking and musing, sore wearied with care and watching, and 
rather slumbered than slept, troubled with fearful dreams : he some- 
times started suddenly up, leaped out of his bed, and ran about his 
chamber: his restless heart was continually tossed and tumbled with 
the tedious impression and stormy remembrance of his horrid and 
abominable deeds." 
15 



114 ON HYGIEINE, OR THE ART 

Conscience, what art thou? thou mysterious pow'r, 

That dost inhabit us without our leave. 

And art within ourselves another self, 

A master self, that loves to domineer, 

And treat the monarch frankly as the slave ; 

How dost thou light a torch to distant deeds. 

Make the past, present, and the future frown ; 

How, ever and anon, wake the soul, 

As with a peal of thunder, to strange horrors! — Shakspeare. 

The rich Cardinal of Winchester, Henry Beaufort, who procured 
the death of the good Duke of Gloucester, was soon after struck with 
an incurable disease ; and, understanding by his physicians, that he 
could not live, he expressed himself thus : " Pie, will not death be 
hired ? Will money do nothing ? Must I die who have so great 
riches? If the whole realm of England would save my life, I am 
able, either by policy to get it, or by riches to buy it." But the 
king of terrors is not to be bribed by gold. It is a pleasure to him 
to mix the brains of princes and politicians with common dust; and 
how loath soever he was to depart, yet grim death would seize 
upon him. 

How shocking must thy summons be, O death! 
To him that is at ease in his possessions ; 
Who, counting on long years of pleasure here, 
Is quite unfurnish'd for the world to come? 
In that dread moment, how the frantic soul 
Raves round the walls of her clay tenement 
Rushes to each avenue, and shrieks for help, 
But shrieks in vain. ****** 
########## The foe 
Like a stanch murderer, steady to his purpose, 
Pursues him close through every lane of life, 
Nor misses once the track, but presses on, 
Till forc'd at last to the tremendous verge, 
At once he sinks to everlasting ruin. — Blair. 

The best remedy against this torturing state of the mind is a good 
conscience, which is to the soul, what health is to the body. It 
preserves a constant ease and serenity within us, and more than 
countervails all the calamities and afflictions that can befall us. 

When the mind has been under the influence of sudden surprise, 
or vehement attention to some interesting object, it has frequently 
suspended, and even entirely cured, ague and fever, asthma, and 
other chronic diseases. 

An officer, of great courage, who had contracted the asthma by 
long service in India, declares, that during a most severe attack of 
that complaint, when he could scarcely breathe in an erect posture, 
and without power to move, as he thought, six yards to save his 
life, the alarm guns were fired for the whole line to turn out, be- 
cause the Mahrattas broke into the camp. Knowing that certain 
death would be his portion if he remained in his tent, he sprung 
out with an alacrity that amazed his attendants, instantly mounted 



OF PRESERVING HEALTH. 115 

his horse , and with great ease drew his sword, which the day before 
he could not move from its scabbard, though he had used his whole 
strength in the attempt. From the instant of the alarm, the de- 
bility left him, together with the asthma, nor did the disorder return 
for some time after. 

" 1 have frequently observed," says the ingenious author of the 
Medical Extracts, " delicate hysterical women, who, for many 
months, had seldom enjoyed one day's health, suddenly relieved 
from every complaint, when a favourite child was attacked with a 
disease, in which danger was apprehended : and they continued in 
appearance, to be in perfect health during the whole course of the 
illness, and exhibited an unusual alertness in discharging their duty 
as nurses and parents. But when they understood that the danger 
was over, their former complaint gradually returned, to their great 
surprise ; for, from the health they had lately enjoyed, and from so 
considerable a time, they believed themselves perfectly cured." 

A very remarkable instance of the influence the mind has upon 
disorders of the body, occurred to the celebrated Boerhaave. A 
person fell down in an epileptic fit in the sight of other patients. 
The effect of this operated so strongly that great numbers of them 
became immediately affected in the same manner. The opinion 
of the great physician above mentioned was requested on this occa- 
sion. He judiciously reflected, that, as these fits were originally 
produced by an impression on the mind, that the most proper means 
of cure would be to eradicate these impressions by others still more 
powerful. He therefore, directed actual cauteries to be prepared, 
and kept hot, in readiness to be applied to the person who should 
next be affected. The consequence tvas, not one person ivas seized. 

Through a most criminal inattention to children in the nursery, 
a foundation is sometimes laid in their tender minds for those super- 
stitious terrors, from which not all their efforts in subsequent life can 
entirely relieve them. I allude to those dismal stories about witches, 
spirits, hobgoblins, raw-head find bloody-bones, wherewith silly 
nurses, especially poor blacks, are so fond of frightening infants. 
Considering the importance of deep impressions made during those 
tender years, parents cannot too strictly forbid every thing of this 
sort ; neither can they ever exceed in their generous labours to illu- 
minate the minds of their children with lofty ideas of their Creator, 
and that mighty power which he will never fail to exert in their 
favour, if they will but be good. 

Timorous persons are more readily infected by contagious disor- 
ders, than those possessed of fortitude. Hence it is we find nurses 
most frequently escape contagion, while persons of a fearful dispo- 
sition contract the disease on entering the chamber of the sick only 
once or twice. 

Persons under a violent fit of fear should be treated like those 
who suffer from any other spasmodic contraction. Tea, a little 
wine, or spirits and water may be given to them : vinegar, lavender- 



116 ON HYGTEINE, OR THE ART 

drops, or spirits of hartshorn may be held to the nostrils; warm 
bathing of the feet, and emollient injections may be of advantage ; 
but above all, the mind ought to be duly composed. — Excessive 
bashfulness borders on fear; it may be corrected by social inter- 
course with persons of a cheerful disposition. 



OF ANGER. 

When reason, like a skilful charioteer, 
Can break the fiery passions to the bit, 
And, spite of their licentious sallies, keep 
The radiant track of glory ; passions, then, 
Are aids and ornaments. # * * Young. 

Resentment of wrong is a useful principle in human nature ; and 
for the wisest purposes was implanted in our frame. It is the neces- 
sary guard of private rights, and the great restraint on the insolence 
of the violent; w T ho, if no resistance were made, would trample on 
the gentle and peaceable. But, in the fulness of self-estimation, we 
are too apt to forget what we are. We are rigorous to offences, as 
if we did not daily entreat Heaven for mercy. It is a vice that few 
persons are able to conceal ; for, if it do not betray itself by external 
signs, such as sudden paleness of the countenance, and trembling 
of the joints, it is more impetuous within. 

Pale and trembling Anger rushes in, 

With falt'ring speech, and eyes that wildly stare ; 

Fierce as the tiger, madder than the seas, 

Desperate, and arm'd with more than human strength, 

He whom Anger stings, drops, if he dies. 

At once, and rushes apoplectic down; 

Or a fierce fever hurries him to hell. — Armstrong. 

Those who feel the approach of anger in the mind, should, as 
much as possible, divert their attention from the object of provoca- 
tion, and remain silent. They should never use loud oaths, violent 
upbraidings, or strong expressions of countenance, or gesticulations 
of the arms, or clenched fists ; as these, by their former associations 
with anger, will contribute to increase it. " I have been told," says 
Dr. Darwin, " of a sergeant or corporal, who began moderately to 
cane his soldiers, when they were awkward in their exercise ; but, 
being addicted to swearing and coarse language, he used soon to 
enrage himself by his own expressions of anger, till, towards the 
end, he w r as liable to beat the delinquents unmercifully." Is this 
not applicable to some of us, in the treatment of our slaves? 

A gentleman in New- Castle county, Delaware, w r as so enraged 
with a neighbouring slave, for persevering, contrary to his orders, to 
visit a female servant in his family, that he bought him of his master, 



OF PRESERVING HEALTH. 117 

at a high price, for the express purpose of getting satisfaction ; that 
is, to give him a severe flogging ; and then to sell him to a negro- 
buyer. What with the bitter curses and blows he inflicted upon the 
poor fellow tied hands and feet, his anger rose at length to a flame 
he could not control, and, by the time the master had lost the power 
to inflict, the poor slave had lost the power to suffer — having literally 
expired under his cruel hands. 

A sea captain, hi Charleston, South Carolina, navigated his vessel 
with the help of three slaves. On some provocation from one of 
them, lie laid hold of the offender, who was so alarmed at his mas- 
ter's look, that he jerked away from him. * Roused to fuiy by such 
an act of treason, as this appeared to him, the master caught up a 
broad axe, and with the looks and voice of a demon, ordered his 

other slaves " to seize the d d villain." Frightened out of their 

wits, they seized their fellow-servant, and the master, black with rage, 
and regardless of his prayers and supplications, had him dragged to 
a block, and in a most barbarous manner struck off his head. 

Although the laws of the land did not sentence these inhuman 
masters to death, yet neither of them long survived their infernal 
acts. The gnawings of a blood-stained conscience soon brought 
them down to the grave* 

Cruelty is the extreme of all vices, an offence to God, abhorrence 
to nature, the grief of good men, and a pleasure only to devils and 
monsters divested of humanity. Justice may take away a man's 
life, to punish his offences, and to deter others by his example, from 
the commission of the same crimes ; but to do it by racks and other 
torments, savours little of humanity, less of Christianity. 

How many millions of men have the Spaniards butchered in 
South America. Bartholomew Casa affirms, that in forty-five years 
they destroyed about ten millions of human souls ; an unaccounta- 
ble way of converting these poor savages to Christianity. These 
millions were butchered outright, and if we add those who died la- 
bouring in the mines, doing the drudgery of asses, oxen, and mules, 
to what a vast number would they amount ? Some of them carry 
burdens upon their backs of a hundred and sixty pounds' weight, 
above three hundred miles. How many of these poor wretches 
have perished by water as well as by land, by diving fathoms deep, 
fishing for pearl, who stay there sometimes half an hour under 
water, panting and drawing the same breath all the while, and are 
fed on purpose with coarse biscuit and dry things, to make thorn 
long winded. And if what is reported be true, they hunt the poor 
Indians with dogs to make themselves sport. There is a story of 
Hathir Cacica, a stout Indian, who, being about to die, was persuaded 
by a Franciscan friar to turn Christian, and then he should go to 
heaven ; Cacica asked him whether there were " any Spaniards in 
heaven?" " Yes," says the friar, " it is full of them." "Slay, 
then," said the Indian, " I had rather go to hell than have any more 
of their company." 



118 ON HYGIEINE, OR THE ART 

A young gentleman in Augusta, Georgia, going to a party in the 
neighbourhood, in a gig, had not got out of the street, before his 
horse balked. The youth, leaping from his gig, and angrily catch- 
ing his horse by the bridle, led him off. Having mounted his gig, 
he cracked his whip, for a second start; but his horse had not gone • 
many steps, before he unfortunately fell back again. — Leaping from 
the gig in a violent rage, he struck his horse over the head with a 
loaded whip, and then attempted to lead him off once more. 
Frighted by such violence, the animal, in place of moving forward, 
drew back. Enraged by such obstinacy, the young man repeated 
his blows with the whip until it broke, which rather increased the 
perturbation of his mind. By this time, finding himself surrounded 
by unwelcome spectators of his brutal conduct, he became more 
furious; and snatching a large club, continued his unmerciful 
blows, until he brought the horse to the ground ; when, after a few 
struggles, his blood and brains flowing copiously, the poor animal 
expired. 

As anger is a short madness, so patience is a recollection of all 
requisite virtues, that enables us to withstand the assaults of the for 
mer, and to behave ourselves like sober and prudent men. 

When Xenocrates came one time to the* house of Plato to visit 
him, he prayed him, "that he would beat his servant for him, in 
regard he himself was not at present so fit to do it, because he was 
in a passion." Another time he said to one of his servants, " that he 
would beat him sufficiently, but that he was angry." 

Forgiveness of injuries, and a merciful disposition towards those 
who have offended us, are not only infallible marks of a great and 
noble mind, but are our indispensable duties as reasonable creatures, 
and peculiarly so as Christians. 

Sir Walter Raleigh, a man of known courage and honour, being 
very injuriously treated by a hot-headed, rash youth, who next 
proceeded to challenge him, and, on his refusal to accept, spit upon 
him, and that too in public, the knight, taking out his handkerchief, 
with great calmness, made him only this reply: " Young man, if I 
could as easily wipe away your blood from my conscience, as I can 
this injury from my face, I would this moment take away your 
life." The consequence was, that the youth, struck with a sudden 
and strong sense of his misbehaviour, fell upon his knees, and 
begged forgiveness. 

Clinias, the Pythagorean, was a person very different both in his 
life and manners from other men. If it chanced at any time that 
he was influenced with anger, he would take his harp, play upon 
and sing to it ; saying, as oft as he was asked the cause of his so 
doing, "that by this means he found himself reduced to the temper 
of his former mildness." 

There is a charm, a power that sways the breast, 

Bids every passion revel or be still; 

Inspires with rage, or all your cares dissolves ; 



OF PRESERVING HEALTH. 119 

Can sooth distraction and almost despair. 

That power is Music. * * * Armstrong. 

So great is the empire of music over all the faculties of human 
nature, and so loud have been the ingenious in celebrating its power 
and praises, that they have left nothing scarcely in heaven, not at 
all in the air, sea, or on the earth, but what, in excess of fancy or 
merit, they have subjected to its dominion for the better. 

Music exalts each joy, allays each grief, 

Expels diseases, softens every pain, 

Subdues the rage of poison, and the plague; 

And hence the wise of ancient days ador'd 

One power of Physic — Melody and Song. — Armstrong. 

While the physician prescribes draughts for curing bodily diseases, 
an able musician might prescribe an air for rooting out a vicious 
passion. 

When the tyrant Eugenius raised that perilous war in the East, 
and money grew short with the Emperor Theodosius, he determined 
to raise subsidies, and to gather from all parts more than before he 
had ever done. The citizens of Antioch bore this exaction with 
so ill a will, that, after they had uttered many outrageous words 
against the emperor, they pulled down his statues and those also of 
the empress his wife. Awhile afterwards, when the heat of their 
fury was past, they began to repent themselves of their folly, and 
considered into what danger they had cast themselves and their city. 
Then did they curse their rashness, confess their fault, implore the 
goodness of God, and with tears, " That it would please him to calm 
the emperor's heart." Their supplications and prayers were solemnly 
sung, with sorrowful tunes and lamenting voices. Their bishop, 
Flavianus, emyloyed himself valiantly, in this needful time, in be- 
half of the city ; made a journey to Theodosius, and did his utmost 
to appease him : but finding himself rejected, and knowing that the 
emperor was devising some grievous punishment; and on the other 
side, not having the boldness to speak again, and yet much troubled 
in his thoughts because of his people, then came this device into his 
head. At such time as the emperor sat at meat, certain young 
boys were wont to sing musically unto him. Flavianus wrought so, 
that he obtained of those who had charge of the boys, that they 
would suffer them to sing the supplications and prayer of the city of 
Antioch. Theodosius, listening to that grave music, was so moved 
with it, and so touched with compassion, that having then the cup 
in his hand, he with his warm tears watered the wine that was in it. 
and forgetting all his couceived displeasure against the Antiochans. 
freely pardoned them and their city. 

" Man may most justly tuneful strains admire, 
His soul is music, and his breast a lyre ; 
A lyre which, while its various notes agree, 
Enjoys the sweet of its own harmony. 



120 ON HYGIEINE, OR THE ART 



What ravishes the soul? what charms the ear? 
'Tis music, though a various dress it wear. 
Beauty is music too, though in disguise, 
Too fine to touch the ear, it strikes the eyes, 
And thro' 'em to the soul, the silent stroke conveys.' 



OF HATRED. 

Infernal Malice, only pining Hate, 

And envy grieving at another's state ; 

When these are in the human bosom nurst, 

Can peace reside in dwellings so accurst? — Hamilton. 

Hatred is a Fury that never sleeps ; ulcerates the soul ; and tor- 
tures it throughout. Hence it never fails to injure the body. 

As admiration, the first of the passions, rises in the soul before she 
has considered whether the thing represented to her be good, or con- 
venient to her, or not; so, after she has judged it to be good, there is 
raised in her the most agreeable and complacent of all passions, 
love ; and when she hath conceived the same to be evil, she is 
quickly moved to Hatred, which is nothing but the soul's aversion 
to that which threatens pain or grief, and may be defined to be " a 
commotion produced by the spirits, that incite the soul to be willing 
to be separated from objects represented to her as ungrateful and 
hurtful;" which definition only respects pure nature; but through 
the coiTuption of men and manners, it may be said to arise from 
an imbibed prejudice, or envy aggravated by continuance, and 
heightened by a malicious intention of malignancy, and injuring the 
person to whom we have a disaffection, and that too without any 
reason but what proceeds from a self-contracted wickedness. Anger 
is sometimes allowable, and, when excessive, is still called but the 
vice of men ; but hatred is said to be the sin of devils, being not 
confined at home, but roves abroad, seeking whom it may devour. 

" Cruel revenge, which still we find, 
The weakest frailty of a feeble mind : 
Degenerous passion, and for man too base, 
It seats its empire in the savage race." 

A certain Italian, having his enemy in his power, told him there 
was no possible way for him to save his life, unless he would imme- 
diately deny and renounce his Saviour. The timorous wretch, in 
hope of mercy, did it ; when the other, forthwith, stabbed him to 
the heart, saying, that now he had a full revenge, for he had killed 
at once both his body and soul. 

In the reign of Edward VI., upon the alteration of religion, there 
was an insurrection in Cornwall and divers other counties, wherein 
many were taken and executed by martial law. The chief leaders 



OF PRESERVING HEALTH. 121 

were sent to London, and there executed. The sedition being thus 
suppressed, it is memorable what cruel revenge or sport Sir William 
Kingston, provost-martial, made by virtue of his office, upon men in 
misery. One Boyer, mayor of Bodmin in Cornwall, had been 
amongst the rebels, not willingly, but enforced. To him the provost 
sent word that he would come and dine with him, for whom the 
mayor made great provision. A little before dinner, the provost took 
the mayor aside, and whispered him in the ear, " That an execution 
must that day be done in the town, and therefore required that a 
gallows should be set up against dinner should be over." The 
mayor failed not of his charge. Presently after dinner, the provost, 
taking the mayor by the hand, desired him to lead him to the place 
where the gallows was ; which, when he beheld, he asked the mayoi 
" If he thought it to be strong enough ?" " Yes," said the mayor, 
"doubtless it is." "Well, then," said the provost, " get you up, 
speedily, for it is provided for you." " I hope," answered the mayor, 
"you mean not as you speak?" "In faith," said the provost, 
"there is no remedy, for you have been a busy rebel :" and so, 
without respite or defence, he was hanged. Near the said place, 
dwelt a miller who had been a busy actor in that rebellion, who, 
fearing the approach of the marshal, told a sturdy fellow, his ser- 
vant, that he had occasion to go from home, and, therefore, if any 
came to inquire for the miller, he should not speak of him, but say 
he was the miller, and had been so for three years before. So, 
the provost came, and called for the miller, when out comes the 
servant, and said, " I am the man. The provost demanded, 
how long he had kept the mill ? " These three years," answered 
the servant. Then the provost commanded his men to lay hold of 
him, and hang him on the next tree. At this the fellow cried out, 
" I am not the miller, but the miller's man." "Nay, sir," said the 
provost, " 1 will take you at your word. If thou beest the miller, 
thou art a busy knave, if thou art not, thou art a false lying knave ; 
and, howsoever, thou canst never do thy master better service than 
to hang for him;" and so, without more ado, he was despatched. 

Revenge is but a frailty, incident 

To crazM and sickly minds ; the poor content 

Of little souls, unable to surmount 

An injury, too weak to bear affront. — Dryden. 

Revenge is a great sign of cowardice, when an enemy is at one's 
mercy. There is more bravery and disdain in slighting a private 
enemy, and despising revenge, than in cutting his throat : not that a 
man should be insensible of an injury or affront, but that he should 
not carry his resentments too far, where a gentle revenge is sufficient 
Excellent was the advice that was given to the Romans by the am- 
bassadors of some cities in Etruria: — That since they were men, 
they should not resent any thing beyond human nature ; and that 
in mortal bodies they should not carry immortal feuds. Light inju- 
ries are made none by disregarding them; which, if we revenged, 
16 



122 



ON HYGIEINE, OR THE ART 



grow grievous and burdensome, and live to hurt us, when they 
might die to secure us. It is princely to disdain a wrong; and they 
say, princes, when ambassadors have offered indecencies, used not 
to chide, but deny them audience ; as if silence were the royal way 
to revenge a wrong. 

When the Duke of Alva was in Brussels, about the beginning of 
the tumults in the Netherlands, he had sat down before Hulst, in 
Flanders; and there was a provost-marshal in the army who was a 
favourite of his, and this provost had put some to death by secret 
commission from the duke. There was one Captain Bolea in the 
army, who was an intimate friend of the provost's ; and one evening 
late he went to the captain's tent, and brought with him a confessor 
and an executioner, as it was his custom. He told the captain he 
was come to execute his excellency's commission and marshal law 
upon him. The captain started up suddenly, his hair standing up- 
right, and being struck with amazement, asked him, " Wherein have 
I offended the duke." The provost answered, " Sir, I am not to 
expostulate the business with you, but to execute my commission ; 
therefore, I pray prepare yourself, for there is your ghostly father 
and executioner." So he fell on his knees before the priest, and 
having done, and the hangman going to put the halter about his 
neck, the provost threw it away, and breaking into a laughter, told 
him " there was no such thing, and that he had done this to try 
his courage, how he would bear the terror of death." The captain, 
looking ghastly at him, said, " Then, sir, get you out of my tent, 
for you have done me a very ill office." The next morning, the 
said Captain Bolea, though a young man of about thirty, had his 
hair all turned gray, to the admiration of all the world, and the Duke 
of Alva himself, who questioned him about it; but he would confess 
nothing. The next year the duke was recalled, and in his journey 
to the court of Spain, he was to pass by Saragossa, and this Captain 
Bolea and the provost went along with him as his domestics. The 
duke being to repose some days in Saragossa, the young old Captain 
Bolea told him, " that there was a thing in that town worthy to be 
seen by his excellency, which was a casa de loco, a bedlam house, 
such a one as there was not the like in Christendom." " Well," 
said the duke, "go and tell the warden, I will be there to-morrow 
in the afternoon." The captain having obtained this, went to the 
warden, and told him the duke's intention ; and that the chief occa- 
sion that moved him to it was, that he had an unruly provost about 
him, who was often times subject to fits of frenzy; and, because he 
wished him well, he had tried divers means to cure him, but all 
would not do; therefore, he would try whether keeping him close 
in bedlam for some days would do him any good. The next day 
the duke came with a great train of captains after him, amongst 
whom was the said provost, very shining and fine. Being entered 
into the house about the duke's person, Captain Bolea told the war- 
den, pointing at the provost, " that's the man:" the warden took 



OF PRESERVING HEALTH. 123 

him aside into a dark lobby, where he had placed some of his men, 
who muffled him in his cloak, seized upon his sword, and hurried 
him into a dungeon. The provost had lain there 'wo nights and a 
day; and afterwards it happened that a gentleman, coming out of 
curiosity to see the house, peeped into a small grate where the pro- 
vost was. The provost conjured him, as he was a Christian, to go 
and tell the Duke of Alva his provost was there confined, nor could 
he imagine why. The gentleman did his errand ; and the duke, 
being astonished, sent for the warden with his prisoner. The warden 
brought the provost in cuerpo, full of straws and feathers, madman- 
like, before the duke; who, at the sight of him, burst into laughter, 
asking the warden why he had made him prisoner? " Sir," said 
the warden, "it was by virtue of your excellency's commission, 
brought me by Captain Bolea." Bolea stepped forth, and told the 
duke, " Sir, you have asked me oft how these hairs of mine grew 
so suddenly gray ; I have not revealed it to any soul breathing ; but 
now I'll tell your excellency ;" and so related the passage in Flan- 
ders ; and added — " I have been ever since beating my brains to 
know how to get an equal revenge of him, for making me old be- 
fore my time." The duke was so well pleased with the story, and 
the witiness of the revenge, that he made them both friends. 



OF ENVY. 

####### Malicious Envy rode 

Upon a ravenous wolf, and still did chew 

Between his canker'd teeth, a ven'mous toad, 

That all the poison ran about his jaw: 

But, inwardly, he chewed his own maw 

At neighbours' wealth, that made him ever sad : 

For death it was when any good he saw, 

And wept, that cause of weeping none he had, 

But when he heard of harm, he wax'd wondrous glad. 

He hated all good works, and virtuous deeds, 
And him no less than any like did use ; 
And who with gracious bread the hungry feeds, 
His alms for want of faith, he doth accuse, 
So every good to bad he doth abuse ; 
And eke the verse of famous poet's wit, 
He does backbite, and spiteful poison spews 
From leprous mouth on all that ever writ : 
Such one, vile Envy was. — Spencer. 

To repine at the superior happiness of others, is the nature of 
Envy. It arises from self-love or self-interest, particularly in such 
individuals whom nature has denied certain qualifications of body 
or mind, which they cannot avoid seeing in others. 



124 



OR THE ART 



It is almost the only vice which is practicable at all times, and in 
every place ; the only passion which can never lie quiet for want of 
irritation ; its effects are, therefore, every way discoverable, and its 
attempts always to be dreaded. 

Envy commands a secret band, 

With sword and poison in her hand, 

Around her haggard eye-balls roll, 

A thousand fiends possess her soul. 

The artful, unsuspected sprite, 

With fatal aim, attacks by night. 

Her troops advance with silent tread, 

And stab the hero in his bed ; 

Or shoot the wing'd malignant lie, 

And female honours pine or die. — Cotton. 

Solomon emphatically styles " Envy a rottenness of the bones," 
and we too often witness its baneful effects on those who cherish the 
fatal poison. It shows itself in horrors even on the face of young 
females, who, it might be supposed, could not possess so odious a 
passion. Observe an envious girl, while pleased with herself, appears 
quite, beautiful and pleasing in her manners ; but on the appearance 
of one of her sex, a school-mate , of superior beauty and endow- 
ments, her countenance becomes strangely altered. In like manner 
the spirits become depressed; and, as the body cannot remain un- 
disturbed, when the mind, to which it is so nearly attached, is in 
such misery, the person who is tormented with it cannot enjoy good 
health. For it is the passion of the damned; and, as it richly de- 
serves punishment, it never escapes it. 

A French lady of quality that was well married, and lived in 
plenty, hearing her husband's brother had married a very handsome 
lady with a great fortune, was mightily out of humour, insomuch 
that she perfectly hated all that spoke in commendation of her new 
sister-in-law, and hearing her husband also commend her as a very 
beautiful woman, she bribed a servant in that lady's family to poison 
her; but he, discovering the design, and the lady, being reproached 
for it by the husband, poisoned herself and died. 

Envy's the worst of fiends, procurer of sad events, 
And only good when she herself torments. — Cowley. 

Plutarch compares envious persons to cupping-glasses, which ever 
draw the worst humours of the body to them. Like flies, they 
resort only to the raw and corrupt parts of the body; or, if they 
light on a sound part, never leave blowing upon it till they have 
disposed it to putrefaction. When Momus could find no fault with 
the face in the picture of Venus, he picked a quarrel with her 
slippers ; and so malevolent persons, when they cannot blame the 
substance, will yet represent the circumstance of men's best actions 
with prejudice. The black shadow is still observed to wait upon 
those that have been the most illustrious for virtue, or remarkable 



OF PRESERVING HEALTH. 125 

for some kind of perfection : and to excel in either has been an un- 
pardonable crime. 

"The man who envies, must behold with pain 
Another's joy, and sicken at his gain." 

When Aristides, so remarkable for his inviolable attachment to 
justice, was tried by the people at Athens, and condemned to ban- 
ishment, a peasant unacquainted with the person of Aristides, ap- 
plied to him to vote against Aristides. u Has he done you any 
wrong," said Aristides, " that you are for punishing him in this 
manner?" " No," replied the countryman, "I don't even know 
him ; but I am tired and angry with hearing every one call him 
the just" 

Mutius, a citizen of Rome, was noted to be of such an envious 
and malevolent disposition, that Publius, one day observing him to 
be very sad, said, " Either some great evil has happened to Mutius, 
or some great good to another." 

Medicine cannot cure a disease so odious. Education and im- 
provement of morals are its only antidotes. Envious persons com- 
monly give too much importance to trifles ; hence they ought to be 
instructed to employ themselves in more useful pursuits; to judge 
of things according to their true value, and to accustom themselves 
to a philosophic calmness, learn how to overcome or at least to 
moderate their selfishness ; to counterbalance their expectations with 
their deserts ; and to equal or surpass others in their merits, rather 
than in their pretensions. 



OF AVARICE. 

And, oh ! what man's condition can be worse 

Than his, whom plenty starves and blessings curse ? 

The beggars but a common fate deplore, 

The rich poor man's emphatically poor. 

If cares and troubles, envy, grief, and fear, 

The bitter fruits be what fair riches bear. 

If a new poverty grows out of store, 

The old plain way, ye gods! let me be poor. — Cowlev. 

This vile passion, which frowns at the approach of the stranger, 
clinches the hand against the poor, denies all encouragement of 
public good, and can pinch and starve wife and children, is hardly 
more detestable in a moral point of view, than it is pernicious in a 
physical. It is true, that by his unwillingness to part with his mo- 
ney, the miser is generally a temperate, and even an abstemious 
character, and so far his vice is beneficial to his health ; but, in 
many other respects, this detestable vice operates very hurtfully to 



126 ON HYGIEINE, OR THE ART 

the health of him who is cursed with it. By the extreme eagerness 
to make money, by the distressing fears about keeping it, by the in- 
consolable grief for losing it; besides the heart-aches, the envies 
and jealousies, the sleepless nights, wearisome days, and numberless 
other ills which it inflicts on its slaves, it often ruins their health, 
and brings them down to the grave by some lingering disease, or 
more horrible suicide. History tells us of illustrious villains ; but 
there never was an illustrious miser in nature. 

Can wealth give happiness ? Look round, and see 
What gay distress ! what splendid misery ! 
Whatever Fortune lavishly can pour, 
The mind annihilates, and calls for more. — Young. 

To declaim against riches, is like a hungry man inveighing against 
wholesome food, and a naked man railing at warm clothing ; it is 
spending breath to no purpose, and one would sooner be stigmatized 
with the character of a fool or a madman, than gain belief that the 
harangue is more than a copy of one's countenance, or like the fox 
cursing the grapes that were out of his reach • for there are so many 
good uses to which riches may be employed, that to inveigh against 
them is to satirize upon acts of piety, beneficence, and charity. 
But to be poor in the midst of riches is the most insupportable kind 
of poverty. 

In vain our fields and flocks increase our store, 
If our abundance make us wish for more. — Rose. 

A rich cotton planter in Georgia, in consequence of losing two 
cents in the pound on a crop of cotton, was seized with such a sad- 
ness of heart, that he took to his bed, and refusing to be shaved, 
shirted, or to take suitable nourishment, died miserably. He was a 
bachelor, and his estate, on appraisement, amounted to nearly one 
hundred thousand dollars! 

In York county, Pennsylvania, a farmer so wealthy as to raise one 
hundred bushels of clover seed on his own lands, in consequence of 
losing five dollars per bushel on his clover seed, that is, only getting 
seven dollars in Baltimore, after he had been offered twelve for it at 
home, was struck with such a deadly heart anguish, that he went 
into a fit of despondence, and hung himself. After his death, silver 
to the amount of two hundred thousand dollars was found barrelled 
up in his cellar. 

Vain man! 'tis Heaven's prerogative 

To take, what it first deigned to give, 

Thy tributary breath : 

In awful expectation plac'd, 

Await thy doom, nor impious haste 

To pluck from God's right hand his instruments of death.— Warton. 

Hippocrates, in his espistle to Crateva, the herbalist, gives him 
this advice for the cure of some rich patients, that if it were possible 



OF PRESERVING HEALTH. 127 

he should cut up that weed of Covetousness by the roots, that there 
might be no remainder left, then he might be certain, that, together 
with their bodies, he might cure all the diseases of their minds. 

The same great and learned philosopher wished a consultation of 
all the physicians in the world, that they might advise together upon 
the means how to cure covetousness. It is now above two thousand 
years ago since he had his desire ; and after him a thousand and a 
thousand philosophers have employed their endeavours to cure this 
insatiable dropsy. All of them have lost their labours. The evil 
rather increases than declines under the multitude of remedies. 
There have been a number, in former ages, sick of it ; and this wide 
hospital of the world is as full of patients as ever it was. 



OF INTEMPERANCE. 

We curse not wine — the vile excess we blame; 

More fruitful than the accumulated board, 

Of pain and misery, For the subtle draught 

Faster and surer swells the vital tide ; 

And with more active poison than the floods 

Of grosser crudity convey, pervades 

The far remote meanders of our frame. 

###**## jr or know whate'er 

Beyond its natural fervour hurries on 

The sanguine tide ; whether the frequent bowl, 

High-seasoned fare, exercise to toil 

Protracted, spurs to its last stage tir'd life, 

And sows the temple with untimely snow. — Armstrong. 

Temperance, by fortifying the mind and body, leads to happi- 
ness. Intemperance, by enervating them, ends in misery. — And 
those who destroy a healthy constitution of body by intemperance, 
do as manifestly kill themselves, as those who hang, poison, or 
drown themselves. Virtue is no enemy to pleasure; but, on the 
contrary, is its most certain friend. Her office is to regulate our 
desires, that we may enjoy every pleasure with moderation ; and 
then our relish for them will continue. 

Pleasure, my friend, on this side folly lies ; 

It may be vig'rous, but it must be wise : 

And when our organs once that end attain, 

Each step beyond it is a step to pain. — Cawthorn. 

Anacharsis, the Scythian, in order to deter young men from that 
voluptuousness ever attended with ill effects, applied his discourse 
to them in a parable, telling them that the vine of youthful gratifi- 
cation had three branches, producing three clusters. " On the first," 
says he, "grows pleasure; on the second, sottishness; on the third, 
sadness." 



123 ON HYGIEINE, OR THE ART 

Struck by the powerful charm the gloom dissolves 

In empty air : Elysium opens round 

A pleasing frenzy buoys the lightened soul, 

And sanguine hopes dispel your fleeting cares ; 

And what are difficult, and what was dire, 

Yield to your prowess and superior stars ; 

The happiest you of all that e'er were mad, 

Or are, or shall be, could this folly last. 

But soon your heaven is gone ; a heavier gloom, 

Shuts o'er your head ; and, as the thund'ring stream 

Swoln o'er its banks with sudden mountain rain, 

Sinks from its tumult to a silent brook ; 

So, when the frantic raptures in your breast 

Subside, you languish into mortal man : 

You sleep, — and waking, find yourself undone, 

For, prodigal of life, in one rash night 

You lavistid more than might support three days. 

A heavy morning comes ; your cares return 

With tenfold rage. — Armstrong. 

Drinking- is undoubtedly the most miserable refuge from misfor- 
tune. It is the most broken of all reeds. This solace is truly short- 
lived ; when over, the spirits commonly sinking as much belovi their 
usual tone, as they had been before raised above it. — Hence, a repe- 
tition of the dose becomes necessary, and every fresh dose makes 
way for another, till the miserable man is rendered a slave to the 
bottle; and at length falls a sacrifice to what at first, perhaps, was 
taken only as a medicine. 

Unhappy man, whom sorrow thus and rage, 

Two different ills, alternately engage. 

Whom drinks, alas ! hut to forget ; nor sees 

That melancholy, sloth, severe disease, 

Mem'ry confused, and interrupted thought, 

Death's harbingers, lie latent in the draught, 

And in the flowers that wreath the sparkling bowl, 

Fell Adders hiss, and poisonous serpents roll. — Prior. 

" Were the pleasure of the palate lasting," says Cornaro, " there 
would be some excuse for inebriety ; but it is so transitory, that there 
is scarce any distinguishing between the beginning and the ending; 
whereas the diseases it produces are very durable." 

O'er the dread feast malignant Chemia scowls, 

And mingles poison in the nectar'd bowls; 

Fell gout peeps grinning through the flimsy scene, 

And bloated dropsy pants behind unseen : 

Wrapp'd in his robe, white Lepra hides his stains, 

And silent Frenzy, writhing, bites his chains. — Darwin. 

The story of Prometheus seems to have been invented by physi- 
cians in those ancient times when all things were clothed in hiero- 
glyphic, or in fable. Prometheus was painted stealing fire from 
heaven, which might well represent the inflammable spirit produced 
by fermentation, that may be said to enliven and animate the ma?i 
of clay : whence the conquest of Bacchus, and the heedless mirth 



OF PRESERVING HEALTH. 129 

and noise of his devotees. But the after punishment of those who 
steal his accursed fire, is a vulture gnawing the liver ; which well 
allegorizes the poor inebriate, labouring under painful hepatic 
diseases. Tt is thus beautifully described by Darwin : — 

So when Prometheus braved the Thunderer's ire, 
Stole from his blazing throne ethereal fire, 
And lantern'd in his breast, from realms of day, 
Bore the bright treasure to his man of clay : — 
High on old Caucasus, by Vulcan bound, 
The lean, impatient vulture flutt'ring round; 
His writhing limbs in vain he twists and strains, 
To break or loose the adamantine chains : 
The glutt'nous bird, exulting in his pangs, 
Tears his swoln liver with remorseless fangs. 

Let those who have been enticed frequently to taste spirituous 
liquors, till at length they begin to have a fondness for them, reflect 
a moment on the danger of their situation, and resolve to make a 
speedy and honourable retreat. Remember that custom soon 
changes into habit ; that habit is a second nature, more stubborn 
than the first ; and, of all things, most difficult to be subdued. Re- 
member, that it is by little unsuspecting beginnings, that the unfor- 
tunate vice is generally contracted ; and, when once confirmed ; 
scarcely terminates but with life! Learn, then, in time, to resist 
this bewitching spirit, whenever it tempts you. 

Then will you find yourself so perfectly easy without it, as at 
length never to regret its absence ; nay, peculiarly happy, in 
having escaped the allurements of such a dangerous and insidious 
enemy. 

Those who pride themselves on living fast, and are bent upon 
" a short and merry life," though, in truth, it is a short and misera- 
ble one, will, doubtless, spurn at these admonitions, and run head- 
long to their own destruction. Strange infatuation ! Can you sub- 
mit to such despicable bondage, and tamely give up your freedom 
without one generous struggle? The present conflict remember, 
is not for the fading laurel, or tinselled wreath, for which others so 
earnestly contend, but for those more blooming, more substantial 
honours, which Health, the daughter of Temperance , only can 
bestow. For it is thine, O Health] and thine alone, to diffuse 
through the human breast that genial warmth, that serene sunshine, 
which glow on the cheek, shine in the eye, and animate the whole 
frame ! But, if still you have no regard for this blessing, let me 
remind you of an hereafter I 

" To die — to sleep — to sleep ! perchance to dream — 
Ay, there's the rub /" 

If death were nothing, and naught after death ; 
If, when men died, at once, they ceas'd to be. 
Returning to the barren womb of Nothing, 
Whence they sprang — then might the wretch 
That's weary ol the world, and tired of life, 
At once give each inquietude the slip, 
IT 



130 ON HYGIEINE, OR THE ART 

By stealing out of being when he pleased, 
And by what way, whether by hemp or steel, 
Death's thousand doors are open. Who could force 
The ill-pleased guest to sit out his full time, 
Or blame him if he goes ? Sure, he does well 
That helps himself as timely as he can, 
When able. But if there's an hereafter, 
And that there is, Conscience, uninfluenced, 
And suffer'd to speak out, tells every man ; 
Then must it be an awful thing to die : 
More horrid yet to die by one's own hand. 
Self-murder ! dreadful deed ! our island's shame, 
That makes her the reproach of neighb'ring states : 
Shall JYature, swerving from her earliest dictates, 
Self-preservation, fall by her own act? 
Forbid it Heaven ! Let not, upon disgust, 
The shameless hand be foully crimson'd o'er 
With blood of its own lord. Dreadful attempt! 
Just reeking from self-slaughter, in a rage, 
To rush into the presence of our Judge ; 
As if we challenged him to do his worst,. 
And heeded not his wrath. — Blair. 

It is an invariable law of our present condition, that every plea- 
sure, which is pursued to excess, converts itself into a poison. 
Could we expose to view the monuments of death, they would read 
a lecture on moderation much more powerful than any that the 
most eloquent writers can give. You would behold the graves, 
peopled with the victims of intemperance. You would behold those 
chambers of darkness, hung round, on every side, with the trophies 
of luxury, drunkenness, and sensuality. So numerous would you 
find those victims to iniquity, that it may be safely asserted, where 
war or pestilence have slain their thousands, intemperate pleasure 
has slain its ten thousands. 

By unhappy excesses, how many amiable dispositions have been 
corrupted or destroyed ! how many rising capacities and powers have 
been suppressed ! how many flattering hopes of parents and friends 
have been totally extinguished! Who, but must drop a tear over 
human nature, when he beholds that morning, which arose so 
bright, overcast with such untimely darkness ; that good humour, 
which once captivated all hearts ; that vivacity, which sparkled in 
every company; those abilities which were fitted for adorning the 
highest station, all sacrificed at the shrine of low sensuality ; and one 
who was formed for running the fair career of life in the midst of 
public esteem, cut off by his vices at the beginning of his course ; or 
sunk, for the whole of it, into insignificancy and contempt. 

Would you extend your narrow span, 
And make the most of life you can ; 
Would you, when med'cines cannot save, 
Descend with ease into the grave ; 
Calmly retire like evening light, 
And cheerful bid the world good night ? 
Let temperance constantly preside 
Our best physician, friend, and guide ! 



OP PRESERVING HEALTH. 131 

One of the Fathers justly describes the nature of this beastly vice, 
when he saith of it, that " It is a flattering devil ; a sweet poison ; a 
delightful sin; which he that hath, possesseth not himself; and he 
that acts it, doth not only commit a sin, but is wholly converted into 
sin ; being deserted of his reason, which is at once his counsellor 
and guardian." 

A young gentleman of the most respectable parentage, being 
rather intemperate, was urged by his parents to marry, thinking that 
might produce a change in his habits. He paid his addresses to a 
most amiable young lady, of a fair estate, to whom he was soon 
united in wedlock. — It was not many months after marriage, before 
he resumed his former habits, and what with drinking and gambling 
he very soon exhausted the whole of her fortune. Executions being 
out against him, he was compelled to keep at home, where he did 
nothing but get drunk and abuse his amiable wife. One night, 
filled with rage, he resolved to destroy her, and going at a late hour 
into the kitchen, where she had been constrained to retire from his 
abuse, he continued his opprobrious language to her, and, notwith- 
standing she gave him only loving and kind words, yet he struck 
her over the head with a large stick, which she bore patiently, 
although it much injured her face. He still continuing to rage at 
her, wearied, and in great fear, she rose up and went to the door. 
Here he followed her with a chopping-knife in his hand, with which 
he struck at her wrist, and cut her very much ; no help being near 
but an old woman, who durst not interpose, fearing for her own life, 
who prayed her mistress to sta}^ and be quiet, hoping all would be 
well, and so getting a napkin, bound up her hand with it. After 
this, still railing and raging at his wife, he struck her on the forehead 
with an iron cleaver, whereupon she fell down bleeding; but recov- 
ering herself, upon her knees she prayed unto God for the pardon of 
her own and her husband's sins, praying God to forgive him, as she 
did. But as she was thus praying, the infernal demon, her husband, 
split her skull open with a cleaver, so that she died immediately : 
for which he was apprehended, condemned, and hanged. But so 
callous was the wretch, that even under the gallows he did not 
exhibit any marks of repentance. 

It is a lamentable fact, so great is the infatuation of this vice, that 
few, once deluded, have ever recovered their freedom. Some glo- 
rious instances, however, have occurred, which are surely fine 
encouragement to others. We also have the pleasure to find none 
are greater enemies to vice, than those who formerly were the slaves 
of it, and have been so fortunate as to break their chain and recover 
their liberty. 

A medical gentleman in Virginia, who was married to a most 
amiable lady, by associating with dissipated characters, became, at 
length, intemperate himself. As soon as he acquired habits of in- 
temperance, his disposition was altered, and from an affectionate 
husband he proved very turbulent, and treated his wife so ill that 



132 ON HYGIEINE, OR THE ART 

she was constrained to separate from him. After living a disorderly 
life for some time, he was brought to a sense of reflection, and with 
an entire change of mind and manners, he renounced all vicious 
habits, pleaded guilty before his amiable wife, who was ready to 
forgive, and they have since lived in the utmost harmony. So sen- 
sible is he of the danger of using spirituous and vinous liquors to 
excess, that he will not taste them, lest he should be enticed to 
exceed the bounds of moderation ; and whenever he sees a person 
so inclined, never fails to caution him against so insidious an enemy. 

A gentleman of Maryland, addicted to drunkenness, hearing a 
considerable uproar in his kitchen one night, felt the curiosity to 
step without noise to the door, to know w T hat was the matter; when, 
behold, they were all indulging in the most unbounded roars of laugh- 
ter, at a couple of his negro boys, who were mimicking himself in 
his drunken fits ! — as, how he reeled and staggered ! how he looked 
and nodded, and hiccoughed and tumbled ! The pictures which 
these children of nature drew of him, and which had filled the rest 
with such inexhaustible merriment, struck him with so salutary a 
disgust, that from that night he became a perfectly sober man, to the 
inexpressible joy of his wife and children. 

A very respectable gentleman in Philadelphia had a wife, who, 
by her fondness for strong drink, had almost broken his heart. At 
length he was advised, "as a desperate remedy in a desperate dis- 
ease," to place a barrel of spirits in her closet, and let her kill herself 
as soon as possible, since every persuasive means had been used in 
vain to break her of this beastly vice. At the sight of so extraordi- 
nary a visitant in her closet, she was struck with such horror at the 
idea of the dreadful design on which it was placed there, that she 
was immediately reclaimed, and recovered all the purity and lustre 
of her former character, to the infinite joy of her husband, children, 
and numerous friends. 

O Temperance ! support and attendant of other virtues ! Preserver 
and restorer of health ! Maintainer of the dignity and liberty of ra- 
tional beings, from the wretched, inhuman slavery of Sensuality, 
Taste, Custom, and Example ! Brightener of the understanding and 
memory ! Sweetener of life and all its comforts ! Companion of 
reason, and guardian of the passions ! Bountiful rewarder of thy 
admirers and followers ! how do thine excellencies extort the un- 
willing commendation of thine enemies ! and with what rapturous 
delight can thy friends raise up a panegyric in.lhy praise ! 



OP PRESERVING HEALTH. 133 



OF GAMING. 

The love of gaming is the worst of ills ; 

With ceaseless storms the blacken'd soul it fills; 

Inveighs at Heaven, neglects the ties of blood 

Destroys the power and will of doing good ; 

Kills health, pawns honour, plunges in disgrace, 

And, what is still more dreadful — spoils her face. — Young. 

While gaming keeps within the bounds of innocent diversion, to 
recreate the body, or compose the mind, and is not tainted with 
covetousness or passion, the most strait-laced casuist will not censure 
or condemn it as a crime ; but, when it breaks the limits of modera- 
tion, and transports men into heats, swearing, cursing, reproaching, 
and lying; or is taken up as a trade to live by, and pushed on by 
a covetous desire to enrich ourselves by the loss and ruin of one's 
neighbour, it is absolutely unlawful, carefully to be avoided, and 
utterly abominated, as the certain procurer of repentance, sorrow, 
grief, disease, derision, beggary, and contempt. To play sometimes 
to entertain company, says the Marquis of Halifax, or to divert your- 
self, is not to be disallowed ; but to do it so often as to be called a 
gamester, is to be avoided, next to the things that are most criminal. 
It has consequences of several kinds not to be endured ; it will en- 
gage you into a habit of idleness and ill hours, draw you into bad 
company, make you neglect your business, bring you to poverty and 
disgrace, and cause sleepless nights, and destroy health. 

What fool would trouble Fortune more, 

When she has been too kind before ; 

Or tempt her to take back again 

What she had thrown away in vain, 

By idly venturing her good graces 

To be dispos'd of by umes-aces ; 

Or settling it in trust, to uses 

Out of his power, on trays and deuces; 

To put it to the chance, and try, 

P th' ballot of a box and die, 

Whether his money be his own, 

And lose it, if he be o'erthrown ; 

As if he were betray'd, and set 

By his own stars to every cheat, 

Or wretchedly condemned by Fate 

To throw dice for his own estate. — Butler. 

It is true, as it is lamentable in the age in which we live, there 
are too many of all qualities and conditions excessively addicted to 
this abominable vice ; by which many respectable families have 
been reduced from affluence to extreme poverty. But the evil does 
not stop here : it must be fresh in every memory, of the most dia- 
bolical acts having been perpetrated by persons who enlisted under 
the banners of a gambler, and squandered away their estate. Let 



134 ON HYGIEINE, OR THE ART 

the following melancholy catastrophe, which I have from the best 
authority not long since took place, prove a warning to others. 

Mr. A. S , who had a very comfortable support, was enticed 

to associate himself with gamblers, and in a short time lost all that 
he possessed, at cards and dice, which ought to have been treasured , 
up for the subsistence of his family. Reflecting on the foolish man- 
ner in which he had thrown away his money, and beholding his 
children cry about him for victuals, so diseased his mind, that taking 
advantage of his wife's absence, he cut the throats of his three 
children, and then hung himself. His wife, on returning home, 
being so much affrighted at the sight of so barbarous a tragedy, fell 
dead upon the spot. 

An old ruined gamester, in hopes to make a bubble or prey of a 
young gentleman that came to town with his pockets full of money, 
took him to a gaming-house, and there, to encourage him to play, 
showed him several topping sparks that were born to no fortune, 
who by play had purchased great estates, and lived in pomp and 
splendour, by success in shaking their elbows — " You show me," 
says the young gentleman, " the winners, but I pray what has be- 
come of the losers?" To which the old prig making no reply, a 
third person, overhearing their conversation, told the young gentle- 
man, that since the other was silent and confounded with shame at 
the question, he would oblige him with an answer — " Many of the 
losers," saith he, " taking the highway to repair their losses, have 
been hanged ; others have gone to sea to earn their bread ; some 
have taken up the trade of being bullies to bawdy-houses ; others 
that have not hid themselves as servants under a livery, are begging 
or mumping about the streets, or starving in jails for debt, where you 
will be ere long, if you follow that rascal's counsel." " The punish- 
ment," says the young gentleman, " is fit for the sin, when men 
possessed with great sums of their own money, will play the fool to 
make it another man's ; and, if this be the humour of the town, I 
will return again to the country, and spend my estate among my 
neighbours and tenants, where you, sir," speaking to the gentleman 
that dealt so plainly with him, " shall be very welcome." 



OF VANITY. 



So weak are human kind by Nature made 

Or to such weakness by their vice betrayed ; 

Almighty Vanity ! to thee they owe 

Their zest of pleasure, and their balm of wo. — Young. 

Yanity consists of an agreeable reverie ; and is well ridiculed in 
the story of Narcissus, who so long contemplated his own beautiful 
image in the water, that he died from neglect of taking sustenance. 



OF PRESERVING HEALTH. 135 

On the green margin sits the youth, and laves 
His floating train of tresses in the waves ; 
Sees his fair features paint the streams that pass, 
And bends for ever o'er the watery glass. — Darwin. 

As the vain found their claims on qualities which they do not 
possess, they frequently meet with mortifications ; while their ex- 
treme solicitude for distinctions they are not entitled to, can never 
allow them any repose ; hence, vanity is an enemy to health. 

Observe a lady at a ball, anxious to be thought the finest woman 
in the assembly, and doubtful of success. The pleasure, which it 
is the purpose of the assembly to enjoy, is lost to her. She does 
not for a moment experience such a sensation; for it is totally 
absorbed by the prevailing sentiment, and the pains she takes to 
conceal it. She watches the looks, the most trivial marks of the 
opinion of the company, with the attention of a moralist, and the 
anxiety of a politician ; and wishing to conceal from every eye the 
torment she feels, her affection of gaiety at the triumph of a rival ; 
the turbulence of her conversation when that rival is applauded ; 
the over-acted regard which she expresses for her; and the unne- 
cessary efforts which she makes, betray her sufferings and constraint. 
Grace, that supreme charm of beauty, never displays itself but 
when the mind is perfectly at ease, and when confidence prevails. 

If we take the whole sex together, we shall find those who have 
the strongest possession of men's hearts, are not always eminent for 
their beauty. As pride destroys all symmetry and grace, so affecta- 
tion is a more terrible enemy to fine faces than the small-pox. And 
it will always be found, that the lady who has an humble opinion 
of herself, will have every body's applause, because she does not 
expect it; while the vain creature loses approbation through too 
great a sense of deserving it, by her own affectation. 

If a beautiful, proud, and gay woman, would but seriously reflect 
what a loathsome carcass she must ere long become in the grave, 
amidst worms and corruption, it would tend to mortify her pride, 
lessen her vanity, and teach her to be humble. 

Ye proud, ambitious, wealthy, young, and gay, 

Who drink the spirit of the golden day, 

And triumph in existence, come with me, 

And in the mould'ring corpse your picture see, 

What you, and all, must soon or later be. — Solitary Walks 

" Pride, well placed and rightly defined, is of ambiguous insignifi- 
cation," says the late incomparable Marquis of Halifax : " one kind 
being as much a virtue as the other a vice." But we are naturally 
so apt to choose the worst, that it has become dangerous to commend 
the best side of it. Pride is a sly, insidious enemy, that wounds 
the soul unseen, and many, who have resisted other formidable 
vices, have been ruined by this subtle invader ; for, though we smile 
to ourselves, at least ironically, when flatterers bedaub us with false 
encomiums; though we seem many times angry, and blush at our 



136 ON HYGIEINE, OR THE ART 

praises; yet our souls inwardly rejoice; we are pleased with it, and 
forget ourselves. Some are proud of their quality, and despise all 
below it ; first, set it up for the idol of a vain imagination, and then 
their reason must fall down and worship it. They would have the 
world think, that no amends can be made for the want of a great 
title. They imagine, that with this advantage, they stand upon the 
higher ground, which makes them look down upon merit and virtue 
as things inferior to them. Some, and most commonly women, are 
proud of their fine clothes ; and when they have less wit and sense 
than the rest of their neighbours, comfort themselves with the reflec- 
tion that they have more lace. Some ladies put so much weight 
upon ornaments, that, if one could see into their hearts, it would be 
found that even the thought of death was made less heavy to them, 
by the contemplation of their being laid out in state, and honourably 
attended to the grave. The man of letters is proud of the esteem 
the world gives him for his knowledge ; but he might easily cure 
himself of that disease, by considering how much learning he wants. 
The military man is proud of some great action performed by him, 
when possibly it was more owing to fortune than his own valor or 
conduct: and some are proud of their ignorance, and have as much 
reason to be so as any of the rest ; for they being also compared 
with others in the same character and condition, will find their 
defects exceed their acquisitions. 

O, sons of earth ! attempt ye still to rise, 
By mountains piled on mountains to the skies ? 
Heaven still with laughter the vain toils surveys, 
And buries madmen in the heaps they raise. — Pope. 

A person of infinite wit, speaking of what might precisely be 
called a proud and vain man, once said, " When I see him, I feel 
something like the pleasure of seeing a happy couple ; his self-love 
and he live so happily together" 

" Pride was not made for men : a conscious sense 
Of guilt, and folly, and their consequence, 
Destroy the claim, and to beholders tell, 
Here nothing but the shape of manhood dwells." 

" I once saw," says Dr. Darwin, " a handsome young man, who 
had been so much flattered by his parents, that his vanity rose so 
near to insanity, that one might discern, by his perpetual attention 
to himself, and the difficulty with which he arranged his conversa- 
tion, that the idea of himself intruded itself at every comma, or 
pause of his discourse." 

I dreamt that, buried with my fellow clay, 

Close by a common beggar's side I lay ; 

And as so mean an object shock'd my pride, 

Thus, like a corpse of consequence, I cried : 

" Scoundrel, begone ! and henceforth touch me not, 

More manners learn, and at a distance rot." 



OF PRESERVING HEALTH. 137 

" Scoundrel, thou," with haughtier tone, cried he, 
" Proud lump of earth, I scorn thy words and thee ; 
Here all are equal, now thy case is mine. 
This is my rotting place, and that is thine." — Dodd. 

The cure of vanity may be attempted by excess of flattery, which 
will at length appear ridiculous, or, by its familiarity, will cease to 
be desired. " I remember," says Dr. Darwin, " to have heard a 
story of a nobleman, in the court of France, who was so disagreea- 
bly vain in conversation, that the King was pleased to direct his 
cure, which was thus performed. Two gentlemen were directed 
always to attend him ; one was to stand behind his chair, and the 
other at a respectful distance before him : whenever his lordship be- 
gan to speak, one of them always pronounced, " Lord Gallimaufre 
is going to say the best thing in the world." And, as soon as his 
lordship had done speaking, the other attendant pronounced, " Lord 
Gallimaufre has spoken the best thing in the world." Till, in a few 
weeks, this noble lord was so disgusted with praise, that he ceased 
to be in vain, and his majesty dismissed his keepers. 



OF MODESTY 



Hail, Modesty ! fair female honour hails ! 
Beauty's chief ornament, without whose charms, 
Beauty disgusts, or gives but vulgar joys. 
Thou giv'st the smile its grace ; the heightened kiss 
Its balmy essence sweet! — Armstrong. 

Modesty is to virtue, what a fine veil is to beauty. It is one of 
the most distinguishing and attractive characteristics of the female 
sex. It comprises the beauties of the mind, as well as those of the 
body ; and it not only heightens the desire of the male, but deters 
him from rudeness and improper behaviour. It is, therefore, the 
interest of the men to cherish, and not to injure, by indelicacy, a 
quality from which they derive so much pleasure and advantage. 

Naked in nothing should a woman be, 

But veil her very wit and modesty ; 

Let man discover, let not her display, 

But yield her charms of mind without delay. — Young. 

" I remember," says a female author of great distinction, " the 

Count M , one of the most accomplished young men in Vienna, 

when I was there ; he was passionately in love with a girl of peer- 
less beauty. She was the daughter of a man of great rank and 
influence at court ; and, on these considerations, as well as in regard 
to her charms, she was followed by a multitude of suitors. She was 
18 



138 ON HYGIELXE, OR THE ART 

lively and amiable, and treated them all with an affability which 
still kept them in her train, although it was generally known that 
she had avowed a predilection for the count, and that preparations 
were making for their nuptials. The count was of a refined mind 
and delicate sensibility ; and loved her for herself alone ; for the 
virtues which he believed dwelt in her beautiful form ; and, like a 
lover of such perfections, he never approached her without timidity ; 
and when he touched her, a fire shot through his veins that warned 
him not to invade the vermilion sanctuary of her lips. Such were 
his feelings, when, one night, at his intended father-in-law's, a party 
of young people were met to celebrate a certain festival ; several of 
the young lady's rejected suitors being present. Forfeits were one 
of the pastimes, and all went on with a grateful merriment, till the 
count was commanded, by some witty mademoiselle, to redeem his 
glove by saluting the cheek of his intended bride. The count 
blushed, trembled, advanced to his mistress, retreated, advanced 
again — and at last, with a tremor that shook every fibre in his frame, 
with a modest grace, he put the soft ringlets, which played upon 
her cheek, to his lips, and retired to demand his redeemed pledge, 
in evident confusion. His mistress gaily smiled, and the game went 
on. One of her rejected suitors, but who was of a merry, unthink- 
ing disposition, was adjudged by the same indiscreet crier of the 
forfeits, to snatch a kiss from the lips of the object of his recent 
vows. A lively contest between the lady and gentleman lasted for 
a minute ! but the lady yielded, though in the midst of a convulsive 
laugh ; and the count had the mortification, the agony to see the 
lips, which his passionate and delicate love would not allow him to 
touch, kissed with roughness by another man, and one whom he 
despised. Without a word, he rose from his chair, and left the 
room, and the house — and never saw her more ! Thus, by that 
good-natured kiss, the fair boast of Vienna lost a husband and her 
lover. 

Although I consider this act of the count as ridiculously fasti- 
dious, yet I cannot but think it may prove a good hint to my fair 
readers. Certainly the sensitive plant cannot shrink more coyly, 
than should the lovely virgin from the slightest touch of the 
immodest. 

" Learn, then, ye fair, to keep the person sacred j 

###### iik e the pure mine*, 

Be that array'd in modest dignity : 

For e'en its beauties flauntingly expose — 

Thus may ye keep the heart your charms have won." 

The attractive grace and powerful charm of Modesty cannot 
be better illustrated, than by relating the following interesting 
narrative : — 

Charlotte Cor day was tall and well-shaped, of the most graceful 
manners and modest demeanour. There was in her countenance, 



OF PRESERVING HEALTH. 139 

which was beautiful and engaging, and in all her movements a 
mixture of softness and dignity, which were evident indications of 
a heavenly mind. She came to Paris, and, under a feigned pretext, 
gained admission to that republican tyrant, Marat, in whose breast. 
she plunged a dagger, acknowledged the deed, and justified it by 
asserting that it was a duty she owed to her country and mankind, 
to rid the world of such a monster. Her deportment during her 
trial was modest and dignified. — There was a softness so engaging 
in her countenance, that it was difficult to conceive how she could 
have armed herself with sufficient intrepidity to execute the deed. 
Her answers to the questions of the tribunal, were full of point and 
energy. She sometimes surprised the audience by her wit, and 
excited their admiration by her eloquence. Her face sometimes 
beamed with sublimity, and was sometimes covered with smiles. 
She retired while the jury deliberated on their verdict ; and when 
she again entered the tribunal, there was a majestic solemnity in 
her demeanour, which perfectly became her situation. She heard 
her sentence with attention and composure, and left the court with 
serenity, her mind being long before prepared even for the last 
scene. It is difficult to conceive the heroism which she displayed 
in the way to execution. There was such an air of chastened ex- 
ultation thrown over her countenance, that she inspired sentiments 
of love, rather than pity. The spectators, as she passed, uncovered 
their heads before her, and others gave loud tokens of applause. 
She ascended the scaffold with undaunted firmness. When the 
executioner informed her that her feet must be tied to the fatal 
plank, she submitted with a smile. When he took off her hand- 
kerchief, the moment before she bent under the fatal stroke, she 
blushed deeply ; and her head, which was held up to the multitude 
the moment after, exhibited the last impression of offended modesty. 
Such an instance of a young female, given up to destruction, and 
yet so tremblingly alive lo modesty, that even in her last moments 
she resents the slightest insult to that, more than she dreads the exe- 
cutioner's axe, is a display of the charm, as we]] as the force of 
virtue triumphant over death, that deserves to be preserved in ever- 
lasting remembrance. Its effects on the crowd beggared all descrip- 
tion. Admiration held the gazing thousands mute. And though, 
while gazing on her cheeks yet divinely enriched with the blush of 
deathless modesty, they shed their tears over her untimely fate, still 
their joy-glistening eyes seemed to thank her for such a proof of the 
divinity of virtue, and the birth-right to heaven. One of the spec- 
tators, a young man, by the name of Lux, had his feelings wrought 
to such an adoration of her virtues, that he proposed, in a pamphlet 
published the day after, to erect a monument to her honour, and to 
inscribe it with these words :— GREATER THAN BRUTIS 
He was instantly sentenced to the guillotine. He received the 
news with joy, and died exulting that he had the honour of being- 
offered up at the same altar with the immaculate Charlotte Corday. 



140 ON HYGIEINE, OR THE APwT 

As lamps bum silent, with unconscious light, 

So modest ease, in beauty, shines most bright : 

Unarming charms with edge resistless fall, 

And she who means no mischief, does it all. — Hill. 

Plutarch observes, that as thistles, though noxious things in them- 
selves, are usually signs of an excellent ground wherein they grow, 
so bashfulness, though many times a weakness and betrayer of the 
mind, is yet generally an argument of a soul ingenuously and vir- 
tuously inclined. 

We read of many, who, through modesty and fear, when they 
were to speak publicly, have been so disappointed, that they were 
forced to hold their tongue. Thus, Cicero writes of Cario, that being 
to plead in a cause before the senate, he was not able to speak what 
he had premeditated. Also, Theophrastus being to speak before the 
people of Athens, was on a sudden so deprived of memory, that he 
remained silent. The same happened to the famous Demosthenes 
in the presence of King Philip. Nor are we ignorant that the like 
misfortunes have befallen many excellent persons in our times. 

Get that great gift and talent, Impudence, 

Accomplished mankind's highest excellence; 

'Tis that alone prefers, alone makes great, 

Confers alone, wealth, titles, and estate ; 

Gains place at court, can make a fool a peer, 

An ass a bishop, can vil'st blockhead rear 

To wear red hats, and sit in porph'ry chair. — Oldham. 

When once men have bid adieu to modesty, there is nothing so 
unmanly, indecent, or reprehensible; but the brazen brow will 
venture upon; and nothing so high or great that his impudence 
does not pretend a title to. 

A gentleman being asked how it came to pass that he, being a 
man of extraordinary natural parts, and those improved by a uni- 
versity education, foreign travel, diligent study, and the knowledge 
of most European languages ; besides being well born, and having 
many friends to recommend him, missed a considerable employment 
in the government, at a time when there were so many vacancies ? 
The gentleman answered, a The reason is plain ; I have too much 
modesty, and too little impudence, to be preferred, where a higher 
value is put upon the latter than the former." 

For he that has but impudence, 

To all things has a fair pretence ; 

And put among his wants but shame, 

To all the world may lay his claim. — Hudibras. 

An Athenian, of decrepit age, came into the theatre at Athens, on 
a public night, when it was very much crowded. He went to that 
part of the house where his young countrymen were sitting ; but, 
instead of making room for him, they closed their ranks. By 
chance he came to a place where sat some young Lacedemonians 



OF PRESERVING HEALTH. 14.1 

of the first distinction, who, moved with the age of the man, in 
reverence to his years and hoary hairs, rose up, and placed him in 
an honourable seat amongst them ; which, when the people beheld, 
with a loud applause, they approved the modesty of another city. 
At which one of the Lacedemonians said, " It appears that the Athe- 
nians do understand what ought to be done, but they neglect the 
practice of it." 

These young Lacedemonians were heathens. How devoutly 
were it to be wished, that all young Christians would copy so fair 
an example, and learn to treat seniority with a respect equally 
amiable and endearing. 



OF DRESS. 

If the rude verse that now detains your ear, 

Should to one female heart conviction bear ; 

Recall one gentler mind from Fashion's crew, 

To give to Nature what is Nature's due ; 

Whilst others mount the arduous heights of fame, 

To wake your feelings be my nobler aim : 

Nor you unblest, if, whilst I fail to move, 

The fond attempt my kind intention prove. — Roscoe. 

Pliny, one of the most celebrated naturalists of antiquity, pa- 
thetically laments, that, " whilst Nature has given various clothing 
to the brute creation, and even fenced plants and trees with bark 
against the injuries of the cold and heat, she should have cast man 
into this world naked, unprovided against the inclemency of different 
climates and seasons." But, instead of agreeing with that philoso- 
pher, that Nature has, in this particular, acted more like a cruel 
step-mother, than a kind and indulgent parent to man, we cannot 
sufficiently extol her providence and wisdom. It was no more than 
consistent with equity to provide the irrational part of her works with 
clothing suitable to their circumstances; but man, whom she e/idued 
with the transcendent faculty of reason, she hath very wisely left 
to accommodate himself to the difference of season and climate, and 
to clothe himself, accordingly, with the fleeces and skins of animals, 
and the products of various plants and trees. 

Nature knows no other use of clothes but to keep the body warm. 
The shape God has given, is too often attempted to be mended by 
dress; and those who know no better, believe that mankind would 
be frights without its assistance. The bones of growing persons are 
so cartilaginous, that they readily yield to the slightest pressure, and 
easily assume the mould in which they are confined. Hence it is, 
that so many girls, in proportion to boys, are misshapen. 

A lady, whose girls were all misshapen, though her family was 
numerous, consulted the celebrated anatomist, Mr. Cline, on the 



142 OX HYGIEIXE, OR THE ART 

prevention. " To have no stays — and to let the next girl run about 
like the boys" was the excellent advice of this gentleman : which 
being complied with, none of the future children were afterwards 
maired by the ill-placed attention of the ignorant mother. 

" It has been said," observes a celebrated female author, " that 
the love of dress is natural to the sex;" and we see no reason why 
any female should be offended with the assertion. Dress, however, 
to be consistent with the graces and with nature, must be subject to 
certain rules. By attending to these particulars, is produced that 
agreeable exterior which pleases we know not why; which charms, 
even without that first and powerful attraction, beauty. 

<e A beauty* carelessly array'd. 
Enamours more, than if displayed. 

All woman's charms were given, 
And o'er the bosom's vestal white, 
The gauze appears, a robe of light, 

That veils, yet opens heaven," 

Fashion, in her various flights, frequently soars beyond the reach 
of propriety. Good sense, taste, and delicacy, then make their ap- 
peal in vain. Her despotic and arbitrary sway levels and confounds 
Where is delicacy? where is policy? we mentally exclaim, when 
we see the fair inconsiderate votary of fashion exposing, unseemly, 
that bosom which good men delight to imagine the abode of inno- 
cence and truth. Can the gaze of the voluptuous, the unlicensed 
admiration of the profligate, compensate the woman of sentiment 
and purity, for what she loses in the estimation of the moral and 
just? But, delicacy apart, what shall we say to the blind conceit of 
the robust, the coarse, the wanton fair one, who thus obtrudes the 
ravages of time upon the public eye ? 

Nature having maintained a harmony between the figure of a 
woman and her years, it is decorous that the consistency should 
extend to the materials and fashion of her apparel. For youth to 
dress like age, is an instance of bad taste seldom seen. But age 
affecting the airy garment of youth, the transparent drapery of Cos, 
and the sportiveness of a girl, is an anachronism, as frequent as it is 
ridiculous. 

Virgin, bridal beauty, when she arra}'s herself with taste, obeys 
an end of her creation ; that of increasing her charms in the eyes 
of some virtuous lover, or the husband of her bosom. She is ap- 
proved. But when the wrinkled fair, the hoary-headed matron, 
attempts to equip herself for conquest, to awaken sentiments which, 
the bloom of her cheek gone, her rouge can never arouse ; then 
we cannot but deride her folly. There is a mediocrity which bounds 
all things, and even fixes the standard which divides virtue from 
bombast. 

******* "Loveliness 
Needs not the foreign aid of ornament ; 
But is, when unadorn'd, adom'd the most." 



OP PRESERVING HEALTH. 143 

It is worthy of remark, an unaffected beauty carries with it a re- 
spect and superiority that proceeds from the impulse of nature, and 
not from the artifice of those that have it. 

" Taste," says Dr. Knox, " requires a congruity between the in- 
ternal character, and the external appearance." — Another author, 
the discriminating Chesterfield, observed that " A prepossessing ex- 
terior is a perpetual letter of recommendation." 

Hence, we see that the desire of exhibiting an amiable exterior is 
essentially requisite in women. It is to be received as an unequivo- 
cal symbol of those qualities, which we seek in a wife ; it indicates 
cleanliness, sweetness, a love of order, and universal propriety. 
What, then, is there to censure in a moderate consideration of dress? 
Nothing. We may blame, when we find extravagance, profusion, 
misappropriation ; the tyranny of fashion ; slavery to vanity ; in short, 
bad taste! 

Fashions, like manners, still from courts descend, 

And what the great begin, the vulgar end. 

Honour's a mistress all mankind pursue ; 

Yet most mistake the false one for the true : 

Lur'd by the trappings, dazzled by the paint, 

We worship oft the idol for the saint. 

Courted by all, by few the fair is won ; 

Those lose who seek her, and those gain who shun. 

Naked she flies to merit in distress, 

And leaves to courts the garnish of her dress. 

Although we cannot suppose prodigality in dress would recom- 
mend the wearers to persons of sense ; yet we consider that a decent 
habit, proportioned to one's quality and business, is essentially ne- 
cessary. 

Philopsemon, commonly called the Great, was a person of a very 
mean aspect, and one that took no care to set himself off with decent 
apparel, by which means he was often affronted by such people as 
could not distinguish the man from his clothes. He sent notice to 
one of his friends in Megara that he would take a supper with him ; 
who went immediately to market to provide an entertainment, and 
requested his wife, in the mean time, to right up the house, that it 
might be fit to entertain so noble a guest. — Philopasmon, it seems, 
made greater haste than his attendants ; and the wife of the house, 
by the meanness of his dress, taking him to be a servant, employed 
him in cleaving wood for the fire, which he was busy at when his 
friend returned from the market; who, being astonished at the sight, 
said, " Why does my great friend Philopsemon dishonour himself 
and me, by stooping to so mean an office?" The great man, with 
a cheerful and smiling countenance, answered, u I am taking pen- 
ance for my homely face and bad apparel." 

Though we cannot hope entirely to escape the unpleasant sensa- 
tions, or altogether to ward off the fatal effects, occasioned by the 
sudden changes of our climate; yet, considering properly the nature 
of clothings we may avoid much of the danger. If ladies be more 



144 ON HYGIEINE, OR THE .ART 

subject to catch cold frequently than men, it is not alone their deli- 
cacy of constitution, or their being more confined within doors ; but 
the frequent changes they make in the quality and quantity of their 
garments, and sometimes, however fearful of a partial current of air, 
because they expose those parts of the body that a little before had 
been warmly clad. " If," says Dr. Beddoes, " a greater proportion 
of females fall victims to consumption, is it not because, losing sight 
more than men of its primary purpose, they regulate their dress solely 
by fantastic ideas of elegance ?" 

After the high encomiums bestowed upon flannel by so many 
respectable authors, both ancient and modern, and by persons who, 
from long experience, have ascertained its beneficial effects, it is sur- 
prising that any individual should be whimsical or hardy enough to 
dispute its general salubrity, merely with a view to establish his 
favourite hypothesis. 

It has been objected, that flannel worn next the skin is debilita- 
ting, because it too much increases perspiration ; but this is not 
founded on truth, since perspiration, as long as the skin remains 
dry, never can be hurtful. In answer to another objection against 
the wearing of flannel, it is certain that a flannel shirt may preserve 
the body as clean, and much cleaner, than linen, if as frequently 
changed. 

To cold, phlegmatic temperaments ; to all who lead a sedentary 
life; to individuals subject to catarrhs, or frequent colds, gout, 
diarrhoea, and partial congestions of the blood ; to all nervous patients 
and convalescents from severe chronic disorders ; to persons who are 
too susceptible of the impressions of the atmosphere ; and, lastly, in 
such climates and pursuits of life, as are exposed to frequent and 
sudden changes of air, the wearing of flannel next to the skin is cer- 
tainly a salutary dress. It will also be found a better preventive of 
contagion than any other; because while it encourages perspiration, 
it at the same time removes the inhaled poisonous particles. It is a 
mistaken notion that flannel is too warm a clothing for summer. I 
have never found the least inconvenience from wearing it during 
the hottest weather ; but, on the contrary, have experienced the 
greatest advantage. A celebrated author's favourite recipe for health 
was, " to leave off flannel on mid-summer day, to resume it the day 
following." 

To keep an animal in health, beside the retaining of a due degree 
of animal heat, there must be a continual generation of new juices, 
and a perpetual discharge of the old. Without the due quantity of 
perspiration, which, with us, depends very much on our clothing, 
neither the vegetable nor animal can continue in health. A plant, 
whose perspiration is stopped, becomes sickly and dies. Even an 
egg, whose shell has been covered with a varnish, and the perspira- 
tion stopped, will produce no animal. 

Whilst treating on clothing, I would recommend it to every person 
to be careful in observing that the linen which they put on, and the 



OF PRESERVING HEALTH. 145 

sheets in which they sleep be properly dried. Due care should also 
be taken to change the stockings, and other clothing, as speedily as 
possible, after their becoming wet from exposure to rain or snow. 
Those who neglect these cautions will expose themselves either to 
rheumatism, fever, pleurisy, cough, consumption, or some other 
disease of a dangerous or even fatal nature. 



OF CLEANLINESS. 

The grand discharge, of the effusion of the skin, 

Slowly impair' d, the languid maladies 

Creep on, and through the sick'ning functions steal : 

As, when the chilling east invades the spring, 

The delicate Narcissus pines away 

In hectic languor ; and a slow disease 

Taints all the family of flowers, condemned 

To cruel heav'ns. But why already prone 

To fade should beauty cherish its own bane! 

O shame ! O pity ! nipt with pale quadrille. 

And midnight cares, the bloom of Albion dies. — Armstrong. 

Cleanliness may be considered the grand secret of preserving 
beauty as well as promoting health; and, therefore, is applicable 
to all ages and sexes. It maintains the limbs in their pliancy ; the 
skin in its softness ; the complexion in its lustre ; the eyes in their 
brightness; the teeth in their purity; and the constitution in its 
fairest vigour. 

The frequent use of tepid baths is not more grateful to the sense, 
than it is salutary to health, and to beauty. By such ablutions all 
impurities are thrown off: cutaneous obstructions removed; and, 
while the surface of the body is preserved in its original brightness, 
many threatening disorders are put to the rout. Indeed, so impor- 
tant is this regimen, that every family should make a bathing vessel 
as indispensable an article in the house as a table. 

Against the rigours of a damp, cold heaven, 
To fortify their bodies, some frequent 
The gelid cistern, and, where naught forbids, 
I praise the dauntless heart. ***** 
With us, the man of no complaint demands 
The warm ablution, just enough to clear 
The sluices of the skin ; enough to keep 
The body sacred from indecent soil. 
Still to be pure, ev'n did it not conduce, 
As much it does, to health, were greatly worth 
Your daily pains. 'Tis this adorns the rich ; 
The want of this is poverty's worst wo — 
With this external virtue, age maintains 
A decent grace ; without it, youth and charms 
Are loathsome. This the venal graces know ; 
19 



146 ON HYGJEINE, OR THE ART 

So, doubtless, do your wives ; for married sires 

As well as lovers, still pretend to taste ; 

Nor is it less, all prudent wives can tell, 

To lose a husband's than a lover's heart. — Armstrong. 

Cleanliness is certainly agreeable to our nature. It sooner attracts 
our regard than even finery itself, and often gains esteem where that 
fails. It is an ornament to the highest, as well as the lowest situa- 
tion, and cannot be dispensed with in either. 

" I had occasion," says the author of the Spectator, " to go a few 
miles out of town, some days since, in a stage-coach, where I had, 
for my fellow-travellers, a dirty beau, and a pretty young quaker 
woman. Having no inclination to talk much, I placed myself back- 
ward, with a design to survey them, and to pick a speculation out 
of my two companions. Their different figures were sufficient to 
draw my attention. The gentleman was dressed in a suit, the 
ground whereof had been black, as I perceived from some few 
spaces that had escaped the powder which was incorporated with 
the greatest part of his coat ; his periwig, which cost no small sum, 
was after so slovenly a manner cast over his shoulders, that it seemed 
not to have been combed since the year 1682 ; his linen, which was 
not much concealed, was daubed with plain Spanish, from the chin 
to the lowest button, and the diamond upon his finger, which naturally 
dreaded the water, put me in mind how it sparkled amidst the rub- 
bish of the mine where it was first discovered. 

" On the other hand, the pretty quaker appeared in all the 
elegance of cleanliness. Not a speck was to be found upon her. A 
clean, oval face, just edged about with little thin plaits of the purest 
cambric, received great advantage from the shade of her black hood ; 
as did the whiteness of her arms from that sober coloured stuff in 
which she had clothed herself. The plainness of her dress was 
very well suited to the simplicity of her phrases; all which, put 
together, gave me an exalted sense of both her good taste and her 
pure innocence. 

" This adventure occasioned my throwing together a few hints 
upon cleanliness, which I shall consider as one of the half-virtues, 
as Aristotle calls them, and shall recommend, under it, the three 
following heads: — As it is a mark of politeness; as it produces 
regard ; and as it bears analogy to purity of mind. 

" First, it is a mark of politeness. It is universally agreed upon, 
that no one unadorned with this virtue, can go into company without 
giving a manifest offence. The easier or higher any one's fortune 
is, this duty rises proportionally. The different nations of the world 
are as much distinguished by their cleanliness, as by their arts and 
sciences. The more any country is civilized, the more they consult 
this part of politeness. We need but compare our ideas of a female 
Hottentot and an English beauty, to be satisfied of what has been 
advanced. 

" In the next place, cleanliness may be said to be the foster-mother 



OF PRESERVING HEALTH. 147 

of Jove. Beauty, indeed, most commonly produces that passion in 
the mind, but cleanliness preserves it. An indifferent face and 
person, kept in perpetual neatness, has won many a heart from a 
pretty slattern. Age itself is not unamiable, while it is preserved 
clean and unsullied ; like a piece of marble constantly kept clean 
and bright, we look on it with more pleasure than a new vessel that 
is cankered with rust. 

" We might observe farther, that as cleanliness renders us agree- 
able to others, so it makes us easy to ourselves ; that it is an excellent 
preservative of health, and that several vices, destructive both to 
mind and body, are inconsistent with the habit of it. — We find, 
from experience, that through the prevalence of custom, the most 
vicious actions lose their horror by being made familiar to us. On 
the contrary, those who live in the neighbourhood of good example, 
fly from the first appearance of what is shocking. It fares with us 
much after the same manner as to our ideas. Our senses, which 
are the inlets of all the images conveyed to the mind, can only trans- 
mit the impressions of such things as usually surround them. So 
that pure and unsullied thoughts are naturally suggested to the mind 
by those objects that perpetually encompass us, when they are 
beautiful and elegant in their kind." 



OF PATRIOTISM. 

Man, through all ages of revolving time, 
Unchanging man, in every varying clime, 
Deems his own land, of every land the pride 
Belov'd by Heaven o'er all the world beside, 
His home a spot of earth supremely blest, 
A dearer, sweeter spot than all the rest. — Montgomery. 

Patriotism, properly defined, is the love of the laws and of the 
commonwealth. It is a sentiment which makes us prefer the interest 
of the public to our own. At the very name of country, the wise 
and brave feel an enthusiasm which renders them invincible. 

Patriotism also contributes greatly to the promotion of good mo- 
rals ; and, hence, to health and every other blessing, both private 
and public. Rome, Athens, and Lacedaemon, owed ail their glory 
to patriotism ; and their nothingness to their forgetfulness of their 
country, their laws, and morals. 

Happy if these awful lessons, read to us in the examples o( the 
great republic of antiquity, could but avail to kindle among our- 
selves that divine patriotism which once exalted them to such glory 
among the nations. Among innumerable other blessings, health 
would then be promoted. For the noble virtues of the soul, con- 



148 ON HYGIEINE, OR THE ART 

stituting patriotism, as magnanimity, disinterestedness, valour, and 
consciousness of doing our duty, would diffuse through the heart 
that habitual complacency and joy most friendly to health ; which 
would be still farther promoted by that simplicity of manners, and 
activity of life, which belong to republicans. Whereas, on the con- 
trary, in proportion as national patriotism decays, health becomes 
enervated by luxury and other vices, which are sure to overspread a 
nation that has lost the animating fire of patriotism. 

John II., king of Portugal, who, for the nobleness of his mind, 
was worthy of a greater kingdom, when he heard there was a bird 
called the pelican, that tears and wounds her breast with her bill, 
that with her own blood she may restore her young ones to life, 
when left as dead by the bitings of serpents, this excellent prince 
took care that the figure of this bird, engaged in this action, should 
be added to his other royal devices ; that he might hereby show, 
that he was ready, upon occasion, to part with his own blood for the 
welfare and preservation of his people and country. Pity it is to 
conceal their names, whose minds have been, in this respect, as 
pious and princely as his, not fearing to redeem the lives of their 
fellow-citizens at the price of their own. 

Themistocles, the Athenian general, after his many famous ex- 
ploits, was banished the country, and sought after to be slain. He 
chose, therefore, to put himself into the power of the Persian king, 
his enemy, rather than to expose himself to the malice of his fel- 
low-citizens. He was by him received with great joy; insomuch, 
that the king, in the midst of his sleep, was heard to cry out thrice, 
aloud, " I have with me Themistocles, the Athenian." He, also, 
did him great honour, for he alloted him three cities for his table 
provisions, and two others for the furniture of his wardrobe and bed. 
While he remained in that court with such splendour and dignity, 
the Egyptians rebelled, encouraged, and also assisted by the Athe- 
nians. The Grecian navy had come as far as Cyprus and Cilicia; 
and Cimon, the Athenian admiral, rode master at sea. This caused 
the Persian king to levy soldiers, and appoint commanders to repress 
them. He also sent letters to Themistocles, then at Magnesia, im- 
porting that he had given him the supreme command in that affair, 
and that he should now be mindful of his promise to him, and un- 
dertake this war against Greece. But Themistocles was no way 
moved with anger against his ungrateful countrymen, nor incited to 
wage war with them by the gift of all his honour and power ; for, 
after having sacrificed, he called about him his friends, and, having 
embraced them, he drank a strong poison, and chose rather to close 
his own life, than to be an instrument of evil to his native country, 
which yet had deserved so ill at his hands. Thus died Themisto- 
cles, in the sixty-fifth year of his age, most of which time he had 
spent in the management of the republic at home, or as the chief 
commander abroad. 

At the siege of Turin by the French army, in 1640, a sergeant 



OF PRESERVING HEALTH. 149 

of the Piedmontese guards signalized himself by a singular example 
of patriotism : this sergeant guarded, with some soldiers, the subter- 
raneous parts of a work of the citadel. The mine was charged, and 
nothing was wanting but what is called a sausage or pudding, to 
blow up several companies of grenadiers who served in the work 
and posted themselves in it. The loss of the work would have ac- 
celerated the surrender of the place. — The sergeant, with great 
resolution, ordered the soldiers he commanded to retire, begging 
them to desire the king his master to protect his wife and children. 
He then set fire to the powder, and perished for his country. 

On the surrender of Lord Cornwallis, in the American war, the 
Loyalist, of 22 guns, then iri the Chesapeake, became a party in 
that disastrous event; her crew were conveyed to the Count de 
Grasse's fleet — of that fleet the Ardent, captured off Plymouth, 
made one, but was then in a very leaky condition. The Count 
being informed that the carpenter of the Loyalist was a man of 
talents, and perfectly acquainted with the nature of the chain pump, 
of which the French were ignorant, ordered him on board the Ville 
de Paris, and addressed him thus : "Sir, you are to go on board the 
Ardent directly; use your utmost skill, and save her from sinking, 
for which service you shall have a premium, and the encouragement 
due to the carpenter of an equal rate in the British navy ; to this I 
pledge my honour ; on refusal, you will, during your captivity, be 
fed on bread and water only." — The tar, surprised at being thus 
addressed in his own language, boldly answered : "Noble Count, I 
am your prisoner. It is in your power to confine me; but never let 
it be said that a British sailor forgot his duty to his king and country, 
and entered, voluntarily, into the service of the enemy; your pro- 
mises are no inducement for me, and your threats shall not force me 
to injure my country." 

There is a land, of every land the pride, 

Belov'd by Heaven o'er all the world beside ; 

Where brighter suns dispense serener light, 

And milder moons emparadise the night, 

A land of beauty, virtue, valour, truth, 

Time-tutor'd age, and love-exalted youth. 

■' Where shall that land, that spot of earth be found!" 

Art thou a man ? — a patriot ? look round ; 

O thou shait find, howe'er thy footsteps roam, 

That land thy country, and that spot thy home ! — Montgomery. 

As Americans, we feel the love of country, not merely because it 
is the land where we were bom, but the land where we enjoy free- 
dom, equal rights, and every blessing that can sweeten life, and gild 
it over with glory. Hence we need not have gone back to ancient 
times to show what men have dared from patriotism. No, thank 
God ! we have, in our own country, and in our own days, names as 
bright as ever adorned the annals of time. The memory of my 
exulting reader is already flying before me to a host of heroes, who 



150 ON HYGIEINR, OR THE ART 

even courted wounds and death for their country; to Lawrence, 
whose last words were "Don't give up the ship!" — to Burrows, 
who, when desperately wounded on the deck, said, " / won't be 
carried below ; prop me up, that I may see my brave men at their 
guns!" — to Lowry Donaldson, who cried, " My gallant country- K 
men, I die, but don't let the cause of freedom die with me!" — to 
Davies, who, on the field of Tippecanoe, smiling in the arms of fate, 
exclaimed, " Thank God, 1 die in the best of causes !" — to a com- 
mon sailor, who, while below, dressing for a mortal wound, and 
hearing his companions on deck shouting for victory, snatched away 
the shattered stump of his arm, saying, " Let me go, doctor : I 
know I am dying, but 1 must give one huzza more for my coun- 
try !" — to Pike, Covington, Gibson, Wood, Holmes, Stoddard, 
Beasley, Mead, Spencer, Wattles, Hoppuck, Jack, Bradford, Armis- 
tead, Yanhorn, Olmstead, Middleton, Woolfolk, Smith, M'Donough, 
Blaney, Legate, Yates, Jackson, O'Fling, of the army — to Allen, 
Ludlow, Wilmer, Funk, Babbit, Hamilton, Howell, Stansbury, 
Gamble, Cowell, Williams, Brookes, Bush, Broome, of the navy — 
to Davis, Allen, Lauderdale, Henderson, Graves, Hickman, Hart, 
M'Cracken, Hooper, Pace, Buel, Hamilton, Evans, Quarles, Brown, 
Belknap, Blakesley, Clagget, Clemm, Rosevelt, Poe, of the mili- 
tia, — and a thousand other Martyrs of Liberty, who all rushed 
into the battle as if animated by the immortal Washington's in- 
junction, — " Remember, that you are going to fight for liberty !" 
and who all died rejoicing that they had shed their blood to cement 
her Holy Fabric. 

" To live with fame the gods allow to many ; but to die with 
equal lustre, is a gift which Heaven selects from all the choicest 
boons of fate, and with a sparing hand on few bestows." 



OF RELIGION. 

Yet, though kind Heav'n points out th' unerring road, 

That leads through nature up to bliss and God ; 

Spite of that God, and all his voice divine, 

Speaks to the heart, or teaches from the shrine, 

Man, feebly vain, and impotently wise, 

Disdains the manna sent him from the skies ; 

Tasteless of all that virtue gives to please, 

For thought too active, and too mad for ease, 

From wish to wish in life's mad vortex tost, 

For ever struggling, and for ever lost; 

He scorns Religion, though her seraphs call, 

And lives in rapture, or not lives at all. — Cawthorn. 

Some of my readers may perhaps be surprised, that in a book 
which professes to treat of Health, I should so far forget the text as 



OF PRESERVING HEALTH. 151 

to introduce the subject of Religion. — But I trust they will cease to 
wonder when they consider that health is the physical result of nicely 
balanced appetites and passions, and that there exists no power on 
earth, that can so attune these into harmony, as Religion. Cast 
your eye around you, and say whence have sprung most of the 
diseases, both mental and corporal, but from lack of this divine guar- 
dian of man, Religion. By this great name, I do not mean that 
hypocrisy which consists in gloomy faces, nor that narrow bigotry 
which rests on particular forms ; the one only shows that religion is 
very galling to their feelings ; the other is but too often false and 
treacherous, deluding those who behold them, into the opinion of 
their superior sanctity and virtue. Nor can I entertain a more fa- 
vourable opinion of those who make a profession of religion, and 
exhibit too much levity. It is a maxim among politicians, " that 
those who know not how to dissemble, know not how to rule." But 
this will not hold in religion, where virtue is at all times to be the 
guide of our actions. 

There are some sectarians who are so illiberal as to express a 
belief, that those only of their persuasion are in the right road to 
heaven ! Strange infatuation ! Can this be consistent with the Scrip- 
tures or reason ? The pure spirit of the gospel of Christ breathes 
forth a holy religion, founded on meekness, charity, kindness, and 
brotherly love. 

Could we forbear dispute, and practise love, 

We should agree as angels do above ; 

Where love presides, not vice alone does find 

No entrance there, but virtues stay behind : 

Both faith and hope, and all the meaner train, 

Of mortal virtues, at the door remain. 

Love only enters as a native there, 

For, born in heaven, it does but sojourn here. — Waller. 

It is of the utmost importance to guard against extremes of every 
kind in religion, lest by seeking to avoid one rock we split upon 
another. It has been long the subject of remark, that Superstition 
and Enthusiasm are two capital sources of delusion. Superstition, 
on the one hand, attaching men with immoderate zeal to the ritual 
and external points of religion, and enthusiasm, on the other, direct- 
ing their whole attention to internal emotions and mystical commu- 
nications with the spiritual world ; while neither the one nor the 
other has paid sufficient regard to the great moral duties of the 
Christian life. 

Blest is the man, as far as earth can bless, 

Whose measur'd passions reach no wild excess ; 

Who, urg'd by Nature's voice, her gifts enjoys, 

Nor other means than Nature's force employs. — Zimmerman. 

In mental illusion, Imagination, when she first begins to exorcise 
her powers, seizes on some fact, of the real nature of which, the 



152 



ON HYGIEINE, OR THE ART 



mind has but an obscure idea, and for want of tracing it through all 
its connexions and dependencies, misleads reason into the darkest 
paths of error. The wild conjectures, and extravagant opinions 
which have issued from this source, are innumerable. — The voice 
of the calm inquirer, Reason, is incapable of being heard amidst 
the tumult, and the favourite image is animated and enlarged by the 
glowing fire of the Passions. No power remains to control or regu- 
late, much less to subdue, this mental ray, which inflames the whole 
soul, and exalts it into the fervour of Enthusiasm, hurries it into 
the extravagance of Superstition, or precipitates it into the furious 
frenzies of Fanaticism. 

The fire of fanaticism is so subtilely powerful, that it is capable of 
inflaming the coldest minds. The rapidity of its progress certainly 
depends, in a great degree, on the nature of the materials on which 
it acts ; but, like every dangerous conflagration, its first appearances 
should be watched, and every means taken to extinguish its flame. 
» " In the course of my practice as a physician," says Dr. Zimmer- 
man, " I was called upon to attend a young lady, whose natural 
disposition had been extremely cheerful, until a severe fit of sickness 
damped her spirits, and rendered her averse to all those lively plea- 
sures which fascinate the youthful mind. The debility of her frame, 
and the change of her temper, were not sufficiently attended to in 
the early stages of her convalescence. The anxiety of her mind was 
visible in the altered features of her face ; and she was frequently 
heard to express a melancholy regret, that she had consumed so 
many hours in the frivolous, though innocent, amusements of her 
age. Time increased, by almost imperceptible degrees, these symp 
toms of approaching melancholy ; and at length exhibited themselves 
by penitential lamentations of the sin she had committed with respect 
to the most trifling actions of her life, and in which no shadow of 
offence could possibly be found. At the time I was called in, this 
superstitious melancholy was attended with certain indications of 
mental derangement. The distemper clearly originated in the in- 
disposition of the body, and the gloomy apprehensions which disease 
and pain had introduced into the mind during a period of many 
months. This once lively, handsome, but now almost insane female, 
was daily attacked with such violent paroxysms of her complaint, 
that she lost all consciousness of her situation, and exclaimed, in 
horrid distraction and deep despair, that her perdition was already 
accomplished, and that the fiends were ivaiting to receive her soul, 
and plunge it into the bitterest torments of hell. Her constitution, 
however, still fortunately retained sufficient strength to enable me, 
by the power of medicine, gradually to change its temperament, and 
to reduce the violence of the fever which had been long preying on 
her life. Her mind became more calm in proportion as her nerves 
recovered their former tone ; and when her intellectual powers were 
in a condition to be acted on with effect, I successfully counteracted 
the baleful effects of Superstition by the wholesome infusion of real 



OF PRESERVING HEALTH. 153 

Religion, and restored, by degrees, a lovely, young, and virtuous 
woman to her family and herself." 

Oh ! would mankind but make fair Truth their guide, 

And force the helm from Prejudice and Pride, 

Were once these maxims fix'd that God's our friend, 

Virtue our good, and Happiness our end, 

How soon must reason o'er the world prevail, 

And Error, Fraud, and Superstition fail, 

None would hereafter, then, with groundless fear, 

Describe the Almighty cruel and severe, 

Predestinating some, without pretence, 

To heaven ; and some to hell for no offence ; 

Inflicting endless pains for transient crimes, 

And favouring sects or nations, men or times. — Zimmerman. 

It is that fervent love of God and man, constituting the heart- 
gladdening religion of Christ, which I mean. This teaches us to 
deny ourselves, and follow in the exercise of all virtues, wherein 
consists the life of religion, laying aside all idle quarrels, self-interest, 
and needless debates about circumstantials ; for this religion is not 
in words, but in works ; not in opinions, but in assurances ; not in 
speculation, but in practice. It is this religion all men ought to love 
for their own sakes, because a holy life, which it teaches, gives a 
comfortable death and a happy eternity. 

He that alone would wise and mighty be, 
Commands that others love as well as he. 
Love as he loved — How can we soar so high? 
He can add wings when he commands to fly. 
Nor should we be with this command dismay'd; 
He that example gives will give his aid. 
For he took flesh, that when his precepts fail, 
His practice, as a pattern, may prevail. — Waller. 

The man who loves God, enjoys that first of felicities, the con- 
sciousness of having placed his affections on the only object that 
truly deserves them. O ! how amiable is gratitude ; especially when 
directed to the Supreme Benefactor. It is the most exalted principle 
that can actuate the heart of man. 

When a good man looks round him on this vast world, where 
beauty and goodness are reflected from every object, and where he 
beholds millions of creatures in their different ranks, enjoying the 
blessings of existence, he looks up to the Universal Father, and 
his heart glows within him. And in every comfort which sweetens 
his own life, he discerns the same indulgent hand. Thus it is that 
gratitude prepares a good man for the enjoyment of prosperity ; for 
not only has he as full a relish as others of the innocent pleasures of 
life, but, moreover, in these he holds communion with God. In all 
that is good or fair he traces his hand. From the beauties of nature, 
from the improvements of art, from the blessings of public or private 
life, he raises his affections to the great Fountain of all happiness 
which surrounds him, and this widens the sphere of his enjoyments, 



154 ON HYGIEINE, OR THE ART 

by adding to the pleasures of sense, the far more exquisite joys of 
the heart. 

If this goodness of God be so admirably seen in the works of 
Nature, and the favours of Providence, with what a noble superiority 
does it even triumph in the mystery of redemption. Redemption is 
the brightest mirror in which to contemplate the most lovely attributes 
of the Deity. 

Redemption! oh, thou beauteous mystic plan, 
Thou salutary source of life to man ! 
What tongue can speak thy comprehensive grace ? 
What thought thy depths unfathomable trace? 
O ! blest Redeemer, from thy sacred throne, 
Where saints and angels sing thy triumphs won ! 
From that exalted height of bliss supreme, 
Look down on those who bear thy sacred name; 
Restore their ways, inspire them by thy grace, 
- Thy laws to follow, and thy steps to trace ; 
Thy bright example to thy doctrine join, 
And by their morals prove their faith divine! — Bovse. 

Religion is so far from debarring us of any innocent pleasure or 
comfort of human life, that it purines our enjoyments, and renders 
them more grateful and generous ; and thus makes us habitually 
cheerful. 

Thou, Cheerfulness, by Heaven design'd 
To sway the movements of the mind ; 
Whatever fretful passion springs, 
Whatever wayward fortune brings 
To disarrange the power within, 
And strain the musical machine ; 
Thou, goddess, thy attempting hand 
Doth each discordant string command; 
Refines the soft and swells the strong, 
And, joining Nature's general song, 
Through many a varying tone unfolds 
The harmony of human souls. — Akenside. 

Cheerfulness is consistent with every species of virtue and prac- 
tice of religion. It bears the same friendly regard to the mind as to 
the body ; it banishes all anxious care and discontent, sooths and 
composes the passions, and keeps the soul in a perpetual calm. 

Providence did not design this tvorld should be rilled with mur- 
murs and repinings, and that the heart of man should be involved 
in perpetual gloom and melancholy. 

What blessings Thy free bounty gives 

Let me not cast away ; 
For God is paid when man receives ; 

T' enjoy is to obey. — Pope. 

As I was between sleeping and waking, says a sublime author, I 
perceived one of the most shocking figures imagination can frame, 
advancing towards me. She was dressed in black, her eyes deep 



OP PRESERVING HEALTH. 155 

sunk in her head, and her complexion pale and livid as the counte- 
nance of death. Her looks were filled with terror and unrelenting 
severity, and her hands armed with whips and scorpions. As soon 
as she came near, with a horrid frown, and a voice that chilled my 
very blood, she bade me follow her. I obeyed, and she led me 
through rugged paths, beset with briers and thorns, and a deep soli- 
tary valley. — Wherever she passed, the fading verdure withered 
beneath her steps ; her pestilential breath infected the air with ma- 
lignant vapours, obscured the lustre of the sun, and involved the 
fair face of heaven in universal gloom. Dismal howlings resounded 
through the forests, from every baleful tree the night raven croaked 
his dreadful note ; and the prospect was filled with desolation and 
horror. In the midst of this tremendous scene, she addressed me 
in the following manner: 

" Retire with me, O rash, unthinking mortal, from the vain allure- 
ments of a deceitful world, and learn that pleasure was not designed 
the portion of human life. Man was born to mourn, and to be 
wretched ; this is the condition of all below the stars, and whoever 
endeavours to oppose it, acts in contradiction to the will of Heaven. 
Fly then from the fatal enchantments of youth and social delight, 
and here consecrate the solitary hours to lamentation and wo. 
Misery is the duty of all sublunary beings, and every enjoyment is 
an offence to the Deity, who is to be worshipped only by the mor- 
tification of every sense of pleasure, and the everlasting exercise of 
sighs and tears." 

This melancholy picture of life quite sunk my spirits, and seemed 
to annihilate every principle of happiness within me. I threw my- 
self beneath a blasted yew, where the winds blew cold and dismal 
round my head, dreadful apprehensions chilled my heart. Here I 
resolved to lie till the hand of death, which I impatiently invoked, 
should put an end to the miseries of a life so deplorably wretched. 
In this sad situation, I espied on one hand of me a deep muddy 
river, whose heavy waves rolled on in slow and sullen murmurs, 
when I found myself suddenly surprised by the sight of the loveliest 
object I ever beheld. The most engaging charms of youth and 
beauty appeared in all her form ; effulgent glories sparkled in her 
eyes, and their awful splendours were softened by the gentlest looks 
of complacency and peace. At her approach, the frightful spectre, 
who had before tormented me, vanished away, and with her all the 
horrors she had caused. The gloomy clouds brightened in cheerful 
sunshine ; the groves recovered their verdure ; and the whole region 
looked gay and blooming as the garden of Eden. I was quite trans- 
ported at the unexpected change, and reviving hope began to glad 
my thoughts, when, with a look of inexpressible sweetness, my 
beauteous deliverer thus uttered her divine instructions : 

" My name is Religion. I am the offspring of Truth and Love, 
and the parent of Benevole?ice, Hope, and Joy. That monster from 
whose power I have freed you, is called Superstition ; she is the 



156 ON HYGIEINE, OR THE ART 

child of Discontent, and her followers are Fear and So?tovj. Thus, 
different as we are, she has often the insolence to assume my name 
and character, and seduces unhappy mortals to think us the same, 
till she at length drives them to the borders of despair ; that dreadful 
abyss, into which you were just going to sink. 

" Look around, and survey the various beauties of the globe, 
which Heaven has designed for the seat of the human race, and 
consider whether a world thus exquisitely framed, could be meant 
for the abode of misery and pain. For what end has the lavish 
hand of Providence diffused such innumerable objects of delight, 
but that all might rejoice in the privilege of existence, and be filled 
with gratitude for the blessings he has sent, is virtue and obedience; 
and to reject them merely as means of pleasure is pitiable ignorance, 
or absurd perverseness. Infinite goodness is the source of created 
existence ; the proper tendency of eveiy rational being, from the 
highest order of raptured seraphs, to the meanest rank of men, is to 
rise incessantly from lower degrees of happiness to higher. They 
have, each, faculties assigned them for various orders of delight." 

" What !" cried I, u is this the language of Religion 9 Does she 
lead her votaries through flowery paths, and bid them pass an unla- 
borious life ?" " The true enjoyments of a reasonable being," an- 
swered she, mildly, " do not consist in unbounded i?idulge?ice, or 
luxurious ease, the tumult of passio?is, the langour of indulgence, 
or $\& flutter of light amusements. Those are often raised into the 
greatest transports of joy, who are subject to the greatest depres- 
sions of melancholy : on the contrary, Cheejfulness, though it does 
not give the mind such an exquisite gladness, prevents us from 
falling into the depths of sorrow. Mirth is like a flash of lightning, 
that breaks through a gloom of clouds, and glitters for a moment. 
Cheerfulness keeps up a kind of day light in the mind, and fills it 
with a steady and perpetual serenity." 

Repinings and secret murmurs of heart give imperceptible 
strokes to those delicate fibres of which we are composed, and wear 
out the machine insensibly ; not to mention the injury they do the 
blood, and those irregular disturbed motions which they raise in the 
vital functions. Whereas Cheerfulness bears the same friendly re- 
gard to the mind as to the body ; it banishes all anxious care and 
discontent, sooths and composes the passions, and keeps the soul in 
a perpetual calm. 

To aim at a constant succession of high and vivid sensations of 
pleasure, is an idea of happiness altogether chimerical. Calm and 
temperate enjoyment is the utmost that is allotted to man. Beyond 
this, we struggle in vain to raise our state ; and, in fact, depress our 
joys, by endeavouring to heighten them. 

Look around you on the world ; reflect on the different societies 
which have fallen under your observation; and think who among 
them enjoys life to most advantage; whether they who, encircled by 
gay companions, are constantly fatiguing themselves in quest of 



OF PRESERVING HEALTH. 157 

pleasure ; or (hey to whom pleasure comes unsought, in the course 
of active, virtuous, and manly life. 

Religion or philosophy calls you not to renounce pleasure, but 
teaches you how to enjoy it. Instead of abridging it, we exhort you 
to pursue it with safety. We propose measures for securing its pos- 
session, and for prolonging its duration. Though she may appear 
to contract the bounds of enjoyment, you will, upon reflection find, 
that in truth she enlarges them : what is delightful in human enjoy- 
ment she readily allows, and not only allows, but heightens, by that 
grateful relish which a good conscience gives to every pleasure ; and 
not only heightens, but adds, when correcting the excess of some 
passions, she gives room for the growth of others. Amid the turbu- 
lence of riot and the fumes of intoxication, unknown are the plea- 
sures of generous friendship, heart-felt love, and domestic society ; 
unknown the conscious satisfaction which accompany honourable 
pursuits, and the justly acquired esteem of those who surround us. 

It was the daily practice of that eminent physician, Dr. Boerhaave, 
throughout his whole life, as soon as he arose in the morning, 
which was generally very early, to retire for an hour to private 
prayer and meditation on some part of the Scriptures. He often told 
his friends, when they asked him how it was possible for him to 
go through so much fatigue, that it was this which gave him spirit 
and vigour in the business of the day. This, therefore, he recom- 
mended, as the best rule he could give: for nothing, he said, could 
tend more to the health of the body, than the tranquillity of the 
mind ; and that he knew nothing which could support himself or 
his fellow-creatures, amidst the various distresses of life, but a well 
grounded confidence in the Supreme Being, upon the principles of 
Christianity. 

We have all of us experienced the effects which any indisposition 
of the body, even though slight, produces on external prosperity 
Visit the gayest and most fortunate man on earth, only with sleepless 
nights, disorder any single organ of the senses, corrode but one of his 
smallest nerves, and you shall presently see all his gaiety vanish ; 
and you shall hear him complain that he is a miserable creature, and 
express his envy at the peasant and the cottager. And can you be- 
lieve that a disease in the soul is less fatal to enjoyment than a dis- 
ease in the animal frame ; or that a sound mind is not as essential as 
a sound body to the happiness of man? Let us rate sensual gratifi- 
cations as high as we please, we shall be made to feel that the seat 
of enjoyment is in the soul. 

Ah ! what is life ? with ills encompass'd round 
Amidst our hopes, fate strikes the sudden wound : 
To-day the statesman of new honour dreams, 
To-morrow death destroys his airy schemes ; 
Is mouldy treasure in thy chest confin'd ? 
Think all that treasure thou must leave behind ! 
Thy heir with smiles shall view the blazoird hearse, 
And all thy hoards with lavish hand disperse. 



158 ON HYGIEINE, OR THE ART 

Should certain fate th' impending blow delay, 
Thy mirth will sicken, and thy bloom decay ; 
Then feeble age will all thy nerves disarm, 
No more thy blood its narrow channels warm. — Gay. 

Let the affections of a man be once softened and dulcified with 
Divine love, and he is ever secure from the sudden apoplexies of 
the passionate, the poisonous cups of the drunkard — the murdering 
pistol of the duellist — the assassinating dagger of the jealous — the 
loathsome diseases of the harlot — and the wasting hectics of the 
gambler. 

Though it is an ill man's interest there should be no God, because 
then there should be no punishment for sin, and though this interest 
passes into argument, yet it is never so conclusive as to pass into an 
entire satisfaction ; for we cannot believe any person that has the use 
of his rational faculties, and gives himself the liberty of thinking, can 
deny the existence of a Deity, both as to creation and providence. 
Then, if every man believe there is a God, not to live in obedience 
to his precepts is to enhance one's guilt, and bring conscience as a 
witness to convict the offender of wilful transgressions. As for pro- 
fessed atheists, or such as have pretended to be so, and durst presume 
to affront their deities, let others read the blackness of their sin in the 
exemplary punishment that attended it. 

A young gentleman of the city of Florence, in Italy, being ac- 
counted brave and dexterous at single sword, was to duel another 
young man called Forchebene. They were accompanied into the 
field by several of their acquaintance, where a friend saluted the 
fonner with his good wishes, saying, " I pray God give you victory 
over your antagonist." The insolent spark answered, " How can he 
fail to do otherwise?" Forchebene, overhearing them, replied, 
u These blasphemous words will render me the executioner of Divine 
vengeance." To it they went with equal fury, when the combat, 
for some time, was very doubtful ; but at length Forchebene made 
such a home-thrust into his adversary's mouth, that he fixed his 
tongue to his neck, the sword appearing above six inches on the 
other side ; of which wound he died immediately, and had his death 
in the part that offended. 

Oh man ! degenerate man ! offend no more ; 

Go, learn of brutes thy Maker to adore ! 

Shall these through every tribe his bounty own, 

Of all his works ungrateful thou alone ! 

Mark how the wretch his awful name blasphemes, 

His pity spares — his clemency reclaims ! 

Observe his patience with the guilty strive, 

And bid the criminal repent and live ; 

Recall the fugitive with gentle eye, 

Beseech the obstinate he would not die ! 

Amazing tenderness — amazing most 

The soul on whom such mercy should be lost! — Boyle. 

There are many wicked men who will speak unbecoming things 



OF PRESERVING HEALTH. 159 

of God, in a humour of bravado amidst company, but will tremble 
before him in solitude, and shudder at the approach of death. 

Man makes a death which nature never made, 

Then on the point of his own fancy falls, 

And feels a thousand deaths in fearing one. — Young. 

Voltaire, a man who, after having long and too justly been con- 
sidered the patron of infidelity, and after having shown himself 
equally the enemy to every religious establishment, at length, to the 
astonishment of all serious minds, and at the close of a long life of 
nearly eighty years, embraced the Christian religion. 

If a veteran in the cause of infidelity thus close his life and his 
works, does it not greatly behoove those who have been deluded and 
misled by his writings, seriously to look to themselves, and bring 
home this striking example to their hearts. 

O then, while penitence can fate disarm, 

While ling'ring justice yet withholds its arm; 

While heavenly patience grants the precious time, 

Let the lost sinner think him of his crime ; 

Immediate, to the seat of mercy fly, 

Nor wait to-morrow — lest to-night he die. — Boyle. 

If men so prodigal in scattering imprecations and curses upon all 
they are displeased at, would take time to consider what they are 
about before they disgorge them, they would certainly be ashamed 
of the folly of such a practice, because nobody is hurt by it but 
themselves ; for curses, like arrows shot against heaven, fall upon 
the heads of those that throw them out, but can never injure the 
persons or things levelled at. Again, what can be more foolish than 
for men, in common discourse, to make imprecations upon them- 
selves, to confirm the truth of their assertions, which does not more 
than give a handle to their auditors' suspicion ? for good men will 
be believed without them, and scorn to use them ; and bad men can 
never gain credit, but disparage themselves, by so frequently venting 
them ; because, by such bitter asseverations, they seem to suspect 
their own reputation. It is also for want of consideration, and too 
easy a compliance with a scandalous and vicious custom, that men 
of sense, in other matters, upon very slight, and sometimes no occa- 
sion whatever, expose themselves to the wrath of Heaven, by calling 
upon God to damn them, if what they say be false ; when, at the 
same time, they know there is no truth in it, and wish they may 
perish eternally, if they don't do what they never intend when they 
speak it. 

What use of oaths, of promise, or of test, 

Where men regard no God but interest? 

What endless war would jealous nations tear ; 

If none above did witness what they swear ? 

Sad fate of unbelievers, and yet just. 

Among themselves to find so little trust! 

Were Scripture silent, Nature would proclaim. 

Without a God, our falsehood and our shame. — Boyle. 



160 ON HYGIEIXE, OR THE ART 

Among all the nations, there are none so barbarous and cruel, 
none so utterly lost to all the sentiments of humanity and civility, 
but have embraced and continued amongst them the notion of a 
Deity, or some being entitled to their adoration. This is a principle 
so deeply engraven in the very nature of man, that no time, nor 
change, nor chance, hath ever been able to obliterate it ; so that, 
rather than have nothing to worship, men have often been contented 
to adore as gods, even the works of their own hands. And, indeed, 
herein their ignorance and folly is chiefly to be lamented, that they 
have still made choice of any thing, rather than the true God, to pay 
their homage and veneration. In the mean time, they shame some 
of us, in having been more zealous in their superstition, than we are 
in the true religion. 

The Athenians consulted the oracle of Apollo, demanding what 
rites they should make use of in matters of their religion. The 
answer was, " The rites of their ancestors." Returning thither 
again, they said, " The manner of their forefathers had been often 
changed ;" they, therefore, inquired, " What custom they should 
make choice of in so great a variety?" Apollo replied, " The best." 

First to the gods thy humble homage pay ; 

The greatest this, and first of laws obey : 

Perform thy vows, observe thy plighted troth, 

And let religion bind thee to thy oath. 

The heroes next demand thy just regard, 

Renown'd on earth, and to the stars preferrM, 

To light, and endless life, their virtue's sure reward. 

Due rites perform, and honours to the dead, 

To every wise, to every pious shade. 

With lowly duty to thy parents bow, 

And grace and favour to thy kindred show: 

For what concerns the rest of human kind, 

Choose out the man to virtue best inclin'd ; 

Him to thy arms receive; him to thy bosom bind. — Pythagoras. 

The great Lord Burleigh used to say, " I will never trust any 
man not of sound religion: for he that is false to God can never be 
true to rnmi" 

From the very respectful mention which I have so frequently 
made of religion, some of my readers may be charitable enough to 
conclude that I am religious in a high degree. Would to God I 
were. From my soul I wish that my devotedness to religion had 
all my life been equal to the exalted opinion which I entertained of 
it. But, though like most of the human race, I have too often 
neglected my duty in this respect, yet can I say, before my God, 
that I look upon religion as the only true glory and happiness of 
man ; and though worlds were thrown into the opposite scale, yet 
would I not relinquish the joys, imperfect as they are, which I derive 
from it. And from this circumstance I have often been led to think, 
that if I derive so much comfort from the little religion which I 
possess, how truly enviable, how superlatively happy must they be, 



OF PRESERVING HEALTH. 161 

whose whole lives are devoted to her service, and whose hearts are 
perpetually enjoying those sublime pleasures which her unclouded 
smile can impart. 

Arise, my soul, on wings seraphic rise, 

And praise th' Almighty Sov'reign of the skies ; 

In him alone essential glory shines, 

Which not the heaven of heav'ns, nor boundless space confines. 

While this immortal spark of heavenly flame 

Distends my breast, and animates my frame ; 

To thee my ardent praises shall be borne 

On the first breeze that wakes the blushing morn : 

The latest star shall hear the pleasing sound, 

And nature in full choir shall join around, 

When full of thee my soul excursive flies 

Through air, earth, ocean, or thy regal skies ; 

From world to world new wonders still I find, 

And all the Godhead flashes on my mind. 

When wing'd with whirlwinds, vice shall take its flight 

To the deep bosom of eternal night, 

To thee my soul shall endless praises pay ; 

Join, men and angels; join th' exalted lay! — Blacklock. 



2] 



OF 



FEVERS IN GENERAL 



Under this head are comprehended all fevers whatever, by which 
the human frame is affected ; but, as they arise from a great variety 
of causes, and affect persons of very dissimilar constitutions, they 
must, of course, differ in their nature, and require a very distinct 
treatment. 

Two very opposite states of the human body are supposed to give 
rise to fevers, and to form their great and fundamental distinctions. 
The one is called the phlogistic diathesis, or inflammatory disposi- 
tion ; wherein the heart is excited to rapid and strenuous exertions, 
manifested by great strength in the action of the vessels, while the 
blood itself exhibits a more florid hue and denser texture than usual. 

In the other, the brain and the nervous system are more directly 
affected, their energy seems impaired, the force of the heart and ves- 
sels is diminished, the blood is of a looser texture, and the fluids tend 
to dissolution. 

In the first state, when the inflammation originates from external 
causes, as wounds, contusions, or bums, the fever follows the local 
affection, and is in proportion to the degree of inflammation in the 
part affected. Such fevers are called symptomatic. 

This is also the case in certain disorders of the lungs, and other 
viscera, which arise, not from external injuries, but from some vice 
in the part, which gradually brings on inflammation and fever. If 
the local inflammation be removed, the fever is removed also ; if it 
cannot be subdued, but increase gradually, destroying the organiza- 
tion of the part, the patient dies sometimes by the violence of the 
fever, and sometimes merely because an organ essential to life is 
destroyed. 

Cold is found, by universal experience, to give a disposition to 
inflammatory disorders, and heat to those called putrid. # During 
the winter, and early in the spring, pleurisies, peripneumonies, quin- 

* We continue this term in obedience to custom only. For it conveys a 
false view of what really happens in those fevers. Recent experiment and 
more accurate observation, have demonstrated, that putrefaction never takes 
place in a living body. 

The process which sometimes goes on in these malignant fevers, has some 
of the appearance of putrefaction ; but it is, in fact, totally distinct. 



OF FEVERS IN GENERAL. 163 

sies, rheumatisms, and inflammatory fevers prevail. Towards the 
end of summer, and particularly in autumn, fevers of a different na- 
ture, with dysenteries, and putrid ulcerous sore throats, make their 
appearance. 

Although it is true, in general, that cold occasions a disposition to 
disease of an inflammatory nature, and heat to those supposed 
putrescent, yet, persons who take violent exercise in sultry weather, 
or who accidentally fall asleep on the ground, exposed to the beams 
of the mid-day sun, are sometimes seized with fevers of a highly 
inflammatory and dangerous quality; the inflammation directly 
affecting the brain itself, or its membranes. 

The time, in which intermittents and remittents are most preva- 
lent, is the end of summer and beginning of autumn, when heat and 
moisture combine to hasten the corruption of animal and vegetable 
substances, and fill the atmosphere with miasmata. These consid- 
erations reduce it next to a certainty, that something essentially con- 
nected with a marshy soil produces fever, and we can suppose noth- 
ing with so much probability, as the effluvia of stagnant water and 
corrupting animal and vegetable substances. 

And if a certain stoppage of perspiration, from the cold of autumn, 
after the body is relaxed by the heat of summer, be sufficient of 
itself to produce fever in dry and well ventilated countries, where 
there is no reason to think that marsh miasmata prevail, we cannot 
be surprised to find them far more universal and more obstinate in 
low and marshy soils, where the first cause concurs with the second. 

A still more active source of fevers is the effluvia from the living 
human body, which, when long confined, becomes in the highest de- 
gree acrimonious, and gives rise to diseases the most dangerous and 
malignant. Whenever numbers of people are crowded together, the 
air must soon be deprived of its vital ingredient, by repeated respira- 
tion; hence, this infectious matter will be formed, but with most ra- 
pidity in jails, in hospitals, in the holds of ships, and in dirty dwel- 
lings, where its virulent tendency is hastened by nastiness, by un- 
wholesome food, by desponding thoughts, or by the effluvia coming 
from bodies in a diseased state. It communicates its infection not 
only to those who approach the places in which it is generated, and 
the human body from which it flows, but also will remain long en- 
tangled in beds, blankets, and other articles, having been in contact 
with the patient's body, retaining its activity, and capable of infect- 
ing others at a considerable distance of time and place, if, unhappily, 
those contaminated materials be carried abroad. In this manner, 
one person who is not himself infected, may infect another : the first 
person, in such cases, being less predisposed to the diseases than the 
second. 

Although the infection arising from the living human body, is not 
perceived to act at a great distance from its direct source: yet it 
seems most probable that it does not immediately lose its virulency ; 
but after it is diffused in the atmosphere, continues in some degree to 



164 INTERMITTENT, OR AGUE AND FEVER. 

act in conjunction with the miasmata of marshes, with heat, ob- 
structed perspiration, and the other causes of fever, and, according to 
the various proportions of those causes, combined with the circum- 
stances of season, climate, and the constitution of the patient, the 
nature of the fever is determined. 



INTERMITTENT, 

OR AGUE AND FEVER. 

Symptoms. — This is that fever which has, periodically, a clear 
intermission alternating with a return of its paroxysms. Prom the 
length of time between the fits, the species of the fever are distin- 
guished and named. Thus, if the fit return every day, it is termed 
a quotidian ; if every third, a tertian ; if every fourth, a quartan. 
The ague commences with weakness, frequent stretching, and 
yawnings, succeeded by sensations of cold in the back and extremi - 
ties, which increase, until the limbs as well as the body become agi- 
tated with frequent and violent shivering. This continues for some 
time, during which a violent pain of the head and back, and a sen- 
sation resembling a stricture across the stomach, frequently distress 
the patient ; and the sense of the coldness is so great, that no en- 
deavours to obtain warmth are of the least avail. These symptoms, 
subsiding by degrees, give way finally to warm flushings, which in- 
crease, until redness and heat, much greater than natural, are ex- 
tended over the whole body ; the patient at length burning with such 
extreme heat, as to be now as solicitous for the refreshing sensation 
of cold, as he was before anxious to mitigate its violence. After 
these symptoms have existed for some time, they gradually decline ; 
the thirst goes off, the skin is relaxed, and a moisture breaks out on 
the head, which soon becomes general and profuse ; then it slowly 
abates, till it entirely ceases. 

This is the general progress of a regular paroxysm of a well 
formed intermittent; the patient is often left apparently free of 
disease, until the next attack. 

Causes. — The remote causes of ague or autumnal fever are, first, 
ihe effluvia which arises from marshes or moist grounds acted on by 
heat. Secondly, cold y especially when accompanied by moisture, 
which will necessarily act with more certainty, if a predisposition to 
the disease exist. This predisposition may be induced by living 
too sparingly, or on trashy food, excessive fatigue, impeded per- 
spiration, preceding disease, indulgence in spirituous liquors, and, 
in fine, by whatever tends to weaken the system and impoverish 



INTERMITTENT, OR AGUE AND FEVER. 165 

the blood. Hence the poor are more subject to this disease than 
the rich. 

For health consists of spirits and of blood, 

And these proceed from generous wine and food. — Pope . 

Treatment. — In the cure of an ague, whether quotidian, tertian, 
or quartan, much the same plan may be followed ; which is, as far 
as possible, to prevent the disease from being habitual ; for the 
longer it continues, the more it weakens the constitution, and dis- 
poses the glandular viscera, as the liver, spleen, &c, to obstructions, 
and often prepares the habit of dropsies and other chronic diseases. 
So that although this disease be not very alarming in its appearance, 
yet, if injudiciously treated, or neglected, it often draws after it the 
most serious consequences ; and hence merits particular attention. 

The cure of the disease, therefore, calls for an emetic, or a dose 
of calomel and jalap, or salts, senna and manna, to free the bowels 
of their offending contents ; and if the patient be of a full habit, 
with headache, and flushed countenance, the pulse hard and quick, 
showing an inflammatory disposition, blood-letting will be highly 
necessary. 

Having by these means prepared the system, strengthening reme- 
dies should next be employed. Of these, the Peruvian bark # is the 
most celebrated, and may be used with safety in the time of inter- 
mission, provided there exist no swelling or hardness of the viscera. 
In that event the bark must be withheld, until these symptoms are 
rendered milder by the administration of gentle laxatives, blisters, 

* Since the publication of the former editions of this work, the bark has, 
gradually, gone out of use, as an internal remedy, not only in the treatment 
of this disease, but of every other in which it was formerly used. Its place 
is now occupied by the sulphate of quinine, which is a powerful tonic, more 
certain, in its effects than the Peruvian bark, from which it is obtained, as, 
unlike that article, it never disagrees with the stomach when that organ is in 
a proper state to receive any tonic, and from this circumstance, as well as its 
diminutive dose, may be given to children at the earliest age. 

The mode of administering the quinine, in the treatment of this disease is 
as follows : — 

After cleansing the stomach and bowels, as directed above, give one grain 
of the powder, in syrup, or one of the pills, or a tea-spoonful of the solution 
of quinine, (see Dispensatory,) every hour for the five or six hours next pre- 
ceding the expected fit. If by these means a return of the attack be prevented, 
the patient is well, but it will be advisable to continue the quinine, at the rate 
of four or five doses daily, for two or three days, to prevent a relapse. If, on 
the contrary, the means fail and the fit comes on, it would be most prudent to 
repeat the cathartic, and after its operation, recommence the use of the quinine. 

In the treatment of the tertian and quartan forms of this fever, it is not ne- 
cessary, during the days of intermission, or what are called the well clays, to 
give the quinine oftener than once in three or four hours. It should be borne 
in mind, that, neither the quinine nor any other tonic should be given until 
the patient, is entirely free from fever, as such a practice may change the in- 
termittents into the remittent or continued form of fever, or do serious mischiet 
to some of the important, internal organs. 



166 INTERMITTENT, OR AGUE AND FEVER. 

and diaphoretic medicines, as the cathartic and saline mixtures, (see 
Dispensatory^) whose good effects will he greatly aided by diluent 
drinks and abstinence from solid food. 

As soon as the system is properly prepared for the use of the bark, 
it may then be given in such doses as the stomach will bear, and at 
such intervals, that six or eight doses may be taken during the inter- 
mission. Should it disagree with the patient in substance, give it 
in some other form, as the cold infusion, decoction or tincture. (See 
Dispensatory.) 

In the mean time, strict attention must be paid to the habit of 
body : for in vain shall we expect to cure intermittents, if the bowels 
be not kept open and the skin moist. 

When, therefore, the Peruvian bark produces costiveness, five or 
six grains of rhubarb, or some mild purgative, should be added to 
each dose ; and in case of cold phlegmatic habits, with a dry skin, 
the addition of ten or fifteen grains of Virginia snake-root is pecu- 
liarly proper. 

In some constitutions the bark produces severe and copious purging. 
This debilitating effect may be prevented by adding five or six drops 
of laudanum to each dose. And when the patient is troubled with 
sourness on the stomach, flatulence, and pain, take the bark in lime- 
water, or conjoin with each dose, eight or ten grains of salt of tartar, 
or magnesia. 

Notwithstanding every precaution, the bark will not sometimes 
remain on the stomach, and with children it is often difficult for 
them to swallow this medicine. With such patients it should be 
employed externally, as directed below. # 

Some patients are subject to profuse sweats, from debility. In 
such cases the bark should be united with a few grains of the rust 
of steel, or ten or fifteen drops of elixir vitriol, and taken in wine. 
But when these evacuations proceed, as they often do, from an im- 
perfect cure, acoompanied with great and intense heat, during their 
prevalence, we must immediately resort to the preparatory remedies, 
as blood-letting, cathartic and diaphoretic. Sometimes the fever will 
not yield to the bark, even when all the usual preparatory medicines 
have been employed. In such cases we may justly suspect the liver 
to be diseased, particularly if the countenance be either livid, or pale, 
or of a yellowish cast ; and in that event, the use of the bark should 
be suspended until those obstructions be removed. 

For this purpose one of the mercurial pills, (see Dispensatory^) 
should be given night and morning, until ptyalism , that is, a soreness 
of the mouth with increased spitting is produced, which will gene- 

* Take a piece of Holland, cut in form of a waistcoat, and for the lining, get 
humhums of an open texture. Between these cloths, from three to six ounces 
of bark must be closely quilted, and then the waistcoat applied on the naked 
skin. Every two or three days, it will be necessary to rub the jacket between 
the hands. It is sometimes proper to unite snake-root with the bark, in the 
proportion of one ounce of the former to four of the latter. 



INTERMITTENT, OR AGUE AND FEVER. 167 

rally succeed; and when it fails, the nitric acid diluted, and given 
in its usual doses, {see Dispensatory,) may be depended on. After 
a ptyalism is effected, recourse must be had to one or other of the 
strengthening remedies, to give tone to the system. 

From the tenor of these observations it follows, that the Peruvian 
bark is not a remedy to be employed in every case of intermittent 
fevers, but that much caution is necessary in the use of it, lest it be 
turned into abuse. For unless the system be properly prepared by 
suitable remedies, the administration of bark, or any other tonic, is 
an error fraught with the most serious mischief. 

The Peruvian bark being so costly, and not always to be had 
pure, it must afford much pleasure to the benevolent to learn, that 
the block oak bark of America possesses the same virtues as the 
Peruvian, as has been verified by repeated experiments, not only in 
the cure of intermittents, but other diseases hitherto treated with the 
Peruvian bark alone. It may be taken in the same manner, only 
in rather larger doses. In substance it is most efficacious, and if well 
pulverised it will be found more palatable than the Peruvian bark, 
and not so apt to excite vomiting. 

Another mode in which this remedy may be employed to great 
advantage, from its abundance in our countiy, is by bathing twice 
or thrice a day in a strong decoction of it ; which to children, and 
patients whose stomachs will not retain medicine, will prove exceed- 
ingly beneficial. When the black oak bark is not convenient, the 
red oak bark, though less efficacious, should be substituted, as I have 
often witnessed the happiest effects accruing to debilitated persons 
bathing in a strong decoction of it, about hike- warm, particularly 
in the last stage of fevers. Hence this remedy well deserves the 
attention of the planter. 

Professor Barton assures us that he has employed the bark of the 
Spanish oak in gangrene, with the happiest effect, and that he con- 
sidered it, in powder, equal to the best Peruvian bark. (See Oak. 
Materia Medica.) 

The common dog-wood bark, of our country, is also an excellent 
substitute for Peruvian, particularly in the cure of intermittents ; so 
is the bark of the wild cherry-tree, and of the lyriadendron tulipifera, 
or American poplar, all of which may be given in the same forms 
and doses, as the Peruvian bark. (See Materia Medica.) 

The Columbo root, an admirable corrector of bile, is a most useful 
medicine in this complaint, and will often be retained by the stomach, 
when the bark in every form has been rejected. It is, likewise, an 
excellent remedy, joined with steel, as in the form of the tonic pow- 
ders or pills, {see Dispensatory^) for patients disposed to be dropsical, 
or who have a swelling and hardness of the spleen, called ague cake; 
especially if a purge or two have been previously employed, and 
some mercurial action excited in the system, by one or two grains 
of calomel, taken every night and morning for a few weeks. 

Another valuable medicine in the cure of agues, and which has 



16S INTERMITTENT, OR AGUE AND FEVER. 

frequently succeeded when the bark failed, is white vitriol. But, 
like other tonic medicines, it requires that the stomach and bowels 
should be freed of their morbid contents, before any good effects 
can result from its use. Therefore, some evacuating medicine is 
always necessary; after which, one of the vitriolic pills (see Dis- 
pensatory^) may be given every three or four hours during the in- 
termission of fever, gradually repeating the dose, or increasing it, as 
the system becomes habituated to its action. 

Charcoal powder, in doses from a tea to a table spoonful given 
three or four times during the intermission, has often interrupted the 
expected paroxysm, and cut short the disease. 

A scruple of the spider's web, it has been said, in many instances 
hath proved successful, given an hour before the fit of an ague and 
an hour after it. 

But among the remedies of intermittents none is more infallible 
than the solution of arsenic, which may be given with perfect safety 
to persons of every age, beginning with the smaller doses, and pro- 
portioning them to the age of the patient. 

Stimulants administered before the fit, by inducing a salu tary 
change in the system, have frequently overcome the disease. It is 
in this way that emetics are considered useful in the coming on of 
the fit ; so is active exercise, and other stimulants. Cataplasms of 
mustard seed and garlic, or horse radish, applied to the wrists and 
ankles an hour or two previously to the expected fit, will excite a 
degree of inflammation so great as to increase the heat as well as the 
circulation, and have often succeeded. 

I have frequently, in obstinate intermittents, prevented the recur- 
rence of the fit, by giving a large dose of laudanum or ether about 
an horn before the expected paroxysm. But when an inflammatory 
disposition prevails in the system, this remedy should not be resorted 
to, as it may convert the intermittent into a continued fever. 

An emetic given previously to the return, while the perspiration is 
supported by the volatile alkali or Dover's powder, (see Dispensa- 
tory,) in its usual doses, with warm drinks, has also succeeded in 
obstinate cases. It should be observed, however, that when we 
attempt to prevent the paroxysm of an intermittent by sweating, this 
mode of relief must be continued till the period of the paroxysm is 
at an end; or at least till the time when the sweating stage would 
have otherwise commenced. 

Those means which excite terror, surprise, and horror, by produ- 
cing a train of new emotions will prevent the return of paroxysms. 
A man has been pushed into the water ; fire has been cried ; the 
most distressing tidings invented and communicated. All these 
remedies fill the mind with such dread as to counteract the impres- 
sion of the cause ; but in general they are dangerous, and when we 
wish to prevent the fit, we depend rather on tonics, the stimulants, 
and the sudorifics. 

Dr. Kellie, an ingenious surgeon of the British navy, states, that 



INTERMITTENT, OR AGUE AND FEVER. 169 

many instances have occurred of the good effects of compression by 
tourniquets or bandages applied so as to obstruct the circulation in 
two of the extremities. The plan pursued by him was to apply the 
instrument on one thigh, and on one arm, of opposite sides, at the 
same time. In two minutes after the application of the tourniquets 
the shaking and other symptoms of the cold stage entirely ceased, a 
mild hot stage was immediately induced, and the patient found him- 
self quite relieved. After suffering the instruments to remain on for 
about fifteen minutes, they were removed, and the cold symptoms 
did not return. He farther states, that, if the tourniquets be applied 
previously to the accession of the paroxysm, the cold stage will be 
entirely prevented ; and that, where the cold stage of an ague is 
either thus shortened, or altogether prevented, the following hot stage 
will be rendered both milder and of shorter duration. 

As agues are liable to recur, one excellent means of prevention, as 
well as cure, is to wear flannel next to the skin, and to exchange the 
situation where the disease was contracted, for another, even though 
not of a healthier air. This alone has often effected a cure. In like 
manner, a change of medicines is as necessary as a change of air, 
that the body may not become habituated to any one mode of treat- 
ment. Therefore, it ought to be remembered, that neither bark nor 
any other tonic medicine, should be continued longer than a fort- 
night at a time ; but should be changed for another article whose 
virtues are nearly the same. After a week or two, the former may- 
be resumed, in case the disease should prove obstinate ; and, to bring 
about the necessary chances in the constitution, larger doses should 
be given. 

Unquestionably the best method of treating an intermittent con- 
sists in giving an emetic during the intermission, (say gr. xxx. of 
ipecac,) and should this not have a cathartic effect, to administer 
some thorough opening medicine, which should be done in time to 
give the sulphate of quinine. Quinine should not be administered 
at random during the intermission, but in such a way and at such 
periods preceding the fit, as most effectually to counteract its impulse. 
Two grains every hour, should be given, beginning seven or eight 
hours, before the expected chill. The object of this is to set up in 
the system such an impulse as shall effectually resist the periodic 
depression. A grain or two of the extract of Colombo or Gentian 
combined with the quinine will be found an important adjuvant. 
As the chill is wont to return about a week from the last paroxysm. 
the tonic pills should be repeated in the same manner, and at the 
same period of the day. And this should in some obstinate cases. 
be repeated, during two or three weeks, at the same interval of time. 
Should there exist a strong tendency in the patient to a repetition of 
the chills after they have been once broken up, it would be advisa- 
ble for him to change his place of abode, though the distance should 
be ever so short. As it regards blood-letting, it rarely if ever is ne- 
cessary or advisable in any stage of an intermittent. Emetics during 
22 



170 INTERMITTENT, OR AGUE AND FEVER. 

the cold stage have been found serviceable. Six grains of tartar 
emetic to two quarts of warm water, divided into four parts, and one 
part given every ten minutes till it operates freely. It produces a 
free discharge of bile and when the hot stage comes on, it purges 
actively. Cases have occurred in which the paroxysm consisted of 
a succession of chills without being followed by a hot fit. The cold 
bath during the intervals and cordial tonics during the fit, succeeded 
in curing the patient. During the hot stage, the following medi- 
cines will be found beneficial : spirits of Mindererus half an ounce, 
every half hour, or at the same interval, ten grains of salt of tartar 
in a table spoonful of vinegar. Also ten grains of nitre with one- 
sixth of a grain of tartar emetic, or with one grain of ipecacuanha. 
The most suitable drinks will be, warm camomile or bone-set tea. 
Also lemonade. A drink made acid with a little elixir of vitriol. 
Barley-water with vinegar. A drachm of nitre in a pint of linseed 
tea. James' powder, four grains, with one-eighth of a grain of 
opium assisted by warm drink given every hour will prove of great 
service. We are aware that the propriety of blood-letting has had 
warm advocates both in the cold and hot stages of intermittents. 
But we repeat that rarely, if ever, will this measure be found neces- 
sary or beneficial. Its apparent advantage will be more than coun- 
teracted by the debility resulting from it. 

When great debility exists, and the disease is of a veiy obstinate 
character, the following combination will prove beneficial : 

Powdered cinchona two scruples, salt of tartar twelve grains, Vir- 
ginia snake-root tw r elve grains. This should be taken every hour 
for seven or eight hours. 

One tea spoonful and a half of the following may be taken every 
third hour — powdered bark and cream of tartar of each one ounce, 
with cloves pounded thirty in number. 

Five grains of camphor, with a drachm of bark in powder — Or 
three grains of carbonate of ammonia w 7 ith one drachm of bark 
in powder will be found very beneficial when the system requires 
support. 

When there is disease of the liver, one grain of calomel, night and 
morning, should be given to keep the bowels gently open and to 
affect the mouth. 

When the stomach is out of order, indicated by a sense of heavi- 
ness, tightness' of the chest, and sickness of stomach, an emetic should 
first be administered, followed by a purgative, and then the bark in 
form of an enema. 

Salt of tartar fifteen grains, with ten drops of laudanum may be 
given in a table spoonful of vinegar, every two hours. 

When cough is combined with ague, blisters to the breast, linseed 
tea, decoction of mallows, mucilage of gum arabic will be beneficial. 

Regimen. — As to regimen in the cold fit, very little more is ne- 
cessary than warm camomile tea. In the hot fit, the drink may be 
barley water, mint or balm tea, lemonade, toast and water, or cold 



REMITTENT, OR BILIOUS FEVER. 171 

spring water, taken often, but in small quantities at a time. When 
the sweating begins, the drinks just enumerated may be enlivened 
with wine, and if the patient be able to take it, he may be allowed 
a little nourishment. During the intermission, the diet should be as 
nutritious as the patient's appetite and digestion will allow. Every 
thing that tends to keep up a gentle perspiration, and to give tone to 
the vessels is useful ; hence moderate exercise is singularly proper, 
since nothing is more conducive to these beneficial effects. The 
exercise should be of that kind to which the patient has been most 
accustomed ; and taken in the open air, unless wet weather, or a 
damp situation forbid. But the utmost care should be taken, that 
exercise be not pushed to fatigue, which, by inducing debility, car- 
ries thousands, particularly foreigners, to untimely graves. 



REMITTENT, 

OR BILIOUS FEVER. 

Symptoms. — In this fever there is a remission or abatement of 
its violence, but not a total cessation. Like other fevers, it com- 
mences with a sense of coldness and shivering, accompanied by 
violent pains in the head and back, great dejection of spirits, sick- 
ness at the stomach, giddiness, loss of strength, and difficulty of 
breathing. The cold stage is succeeded by a considerable degree of 
heat, the pulse, which in the cold fit was small and quick, becomes 
full, but abates not of its quickness. The pain of the head and 
back increases, and the nausea is augmented, frequently terminating 
in copious vomitings of bile. These symptoms continuing, the skin, 
which had hitherto been hot and dry, becomes moist. Soon after 
this, the symptoms abate, and sometimes cease entirely. The pa- 
tient flatters himself with the hopes of health speedily returning ; 
but, alas! these pleasing illusions, are soon dissipated by another 
attack, which comes on with increased violence. And if the fever 
be not opposed by means early employed and sufficiently powerful, 
a constant delirium and restlessness take place ; the discharges be- 
come very offensive, succeeded by twitchings of the tendons, profuse 
clammy sweats, and convulsions which soon terminate in death. 

Causes. — Remittents are produced from the same causes which 
induce intermittents, but acting here in a more powerful manner. 
Like these, they are most prevalent in the months of August, Sep- 
tember, and October, when heat and moisture combine to hasten the 
corruption of animal and vegetable substances, by impregnating the 
air with noxious exhalations. 



172 REMITTENT, OR BILIOUS FEVER 



Treatment. — In the cure of this fever, all our efforts should be 
made to bring the remission to a complete intermission : and this 
is to be effected by bleeding, cathartics, emetics, and diluents, with 
such medicines as have a tendency to solicit the circulation of the 
fluids to the surface. At the commencement of the disease, where 
there exists much pain in the head, with a hard and quick pulse, 
bleeding will be necessary, and may be repeated if the symptoms 
do not yield to the first operation. But to evacuate the first passages 
of their impure contents is always necessary ; and this is best done 
with calomel and jalap, or salts, senna and manna, and when cir- 
cumstances do not prohibit the use of emetics, they, also, may be 
employed. The extent to which these means are to be carried, can 
only be indicated by the symptoms present, the habit of body, and 
other considerations. It will, in many cases, be proper to exhibit 
an emetic at the first attack, but this may sometimes be forbidden, 
by great irritability of the stomach, or the appearance of inflamma- 
tion. For frequently in diseases of the same origin, and in persons 
very nearly similar, with respect to age, sex, and temperament, one 
will frequently be accompanied with an inflammatory diathesis, 
whilst another will be more of the low, irritable species ; and, con- 
sequently, the treatment must be varied, in proportion to the nature 
and violence of the disease. For among fevers, we see all the in- 
termediate degrees and varieties, from common agues to those of the 
most violent and infectious kinds. 

If the patient be of a strong plethoric constitution, with a hard 
and quick pulse, a deep-seated pain in the eyes, a burning heat at 
the stomach, and flushed countenance, indicative of strong inflam- 
matory disposition, bleeding is absolutely necessary, and should be 
repeated every ten or twelve hours, or oftener, until the inflammatory 
symptoms subside. 

The necessity of diligently evacuating the intestinal canal, must 
be obvious to every person. And it is not always by one or two 
brisk cathartics that this complaint is to be cured ; but the operation 
must be continued until the whole of the bilious matter is evacuated, 
which may be known by the fseces changing their colour and put- 
ting on a natural appearance. When the irritating matter is 
thoroughly evacuated, mild laxatives, as the cathartic mixture, (see 
Dispensatory}) Seidlitz powders, or castor oil, answer very well in 
the course of the disease to keep the body gently open ; but in des- 
perate cases calomel is most to be depended on. And if a ptyalism, 
or a slight salivation be excited by the calomel, the patient has no 
cause of alarm, but rather of joy, as this is a certain indication of 
recovery. How desirable, then, must it be in high stages of bilious 
fever, to have this effect produced as early as possible, by giving 
calomel, and rubbing in mercurial ointment, and dressing the blisters 
with the same. 

Besides the aforesaid evacuants, clysters of warm soap-suds, or 
molasses and water, to which may be added a little vinegar, should 



173 

• 

be employed; as they are not only useful in removing from the 
larger intestines any offending matter present, but also in producing 
the good effects of fomentations. 

Attention having been paid to the state of the bowels, which is 
always necessary because of the constant disposition to accumulate 
bile, such medicine as tend to determine the fluids to the surface, 
are next to be regarded. Of this class are the diaphoretic drops, sa- 
line mixture, Mindererus' spirit, febrifuge and Dover's powder. (See 
Dispensatory.) Either of these may be exhibited in their usual 
doses, every two or three hours ; but in desperate cases the antimo- 
nial powders with calomel, or calomel alone, in small doses, are most 
to be relied on. 

The warm bath admirably promotes insensible perspiration, by 
relaxing the skin, and taking oft the stricture of the vessels ; it, con- 
sequently, should always, when practicable, be used, and if a bathing 
vessel cannot be procured, the extremities should be immersed in 
warm water at least once a day. The temperature of the bath, 
should be regulated by the feelings of the patient, and that which 
affects these most agreeably, should be preferred. 

The cold affusion, by throwing cold water over the patient, or 
sponging the body with vinegar and water, has been attended with 
the best effects in warm climates, particularly if the application be 
made during the height of the paroxysm, when the head is generally 
affected. 

After the inflammatory disposition has ceased, tonics will conside- 
rably hasten the cure ; but, if incautiously used during the fever, as 
unfortunately is too often the case, they w T ill render every symptom 
more violent, and will almost inevitably prolong the disease. How- 
ever, if the patient suddenly becomes giddy, feeble and languid, 
quinine, or bark and wine, must be had recourse to, and given freely 
on the remission ; otherwise it will degenerate into a true nervous 
fever. But we must not mistake the debility which arises from 
oppression, requiring evacuants, for an exhausted state of the system ; 
as, in that case, the use of tonics would be but little better than 
butchery. 

Another medicine of great importance in this disease is the 
Columbo root, which readily checks the vomiting, so frequently an 
attendant, and supports the patient's strength during the use of such 
medicines as are requisite to abate the febrile heat, and to carry off 
the bile. 

After unloading the stomach and intestines, by two or three brisk 
purges, and diminishing the arterial action by bleeding, if requisite, 
a wine glass full of the infusion of Columbo root, or ten or fifteen 
grains of the powder may be given in a cup of mint tea, every two 
or three hours, either conjointly or alternately, with some gentle 
opening medicine, as rhubarb, magnesia, cream o( tartar, or salts, to 
remove the redundant bile by keeping the bowels open. 

Salts, though a nauseous medicine, may be rendered much less 



174 REMITTENT, OR BILIOUS FEVER. 

so by adding a little sugar, acidulated with lemon juice or sharp 
vinegar, as in the form of the cathartic mixture ; and this is an ex- 
cellent aperient, to be exhibited in small doses after the vitiated bile 
has been removed by calomel. A solution of salts^ in Seltzer water, 
is a form still more agreeable. 

During this general treatment, particular symptoms will require 
attention. The headache, for example, which so frequently accom- 
panies this fever, is to be treated by applying to the head, cloths 
wrung out of cold water, or vinegar and water often repeated, until 
the malady is removed ; besides which, a blister should be applied 
between the shoulders. 

As to the vomiting, that depending on the peculiarities of habit, 
is to be variously treated. In some I have found the saline mixture, 
soda powders, or infusion of Columbo, answer very well ; in others, 
a spoonful or two of new milk, or equal parts of milk and lime- 
water, given every hour, have had the happiest effects. A spoonful 
of sweet oil and molasses has proved beneficial, when vomiting is 
accompanied with a burning sensation at the pit of the stomach. 
To others, porter has afforded immediate relief. Never was there a 
more welcome or wonderful illustration of this, than in the case of 
Mrs. Carroll, consort of Daniel Carroll, Esq., of Dudington. 

It was my good fortune to attend this very amiable lady under a 
most violent attack of the bilious fever, with incessant vomiting. 
All the usual remedies were employed, without any good effect, 
which excited considerable alarm. She being in a state of pregnan 
cy, and recollecting that nature sometimes furnished a cure beyond 
the rules of our art, I asked her if there were any article of drink 
to which her appetite particularly led her. a Yes, sir," replied she ; 
"I have been craving to drink some good London poller for two 
days past, but I would not mention it, being under the impression 
you would forbid my taking it." Learning that Dr. Thornton had 
some of that description, I immediately obtained a few bottles, and 
giving her a glass of it, diluted with a little water, it acted like a 
charm, and, in a few weeks, I had the very great satisfaction of 
seeing my fair patient perfectly restored to health. 

The warm bath, or local applications, such as flannels wrung out 
of a warm decoction of camomile flowers, or mint leaves stewed 
in spirits, or equal pans of sweet oil and laudanum rubbed on the 
stomach, have done much good ; and when these fail, a large blister, 
or a* cataplasm of mustard seed, ought instantly to be applied over 
the region of this organ. When the stomach is in a very irritable 
state, the patient may frequently moisten his mouth and throat with 
cold water, but should drink as little as possible of any liquid. 

Wakefulness, or inability to sleep, will often yield to the warm 
bath and blisters ; and when they fail, a glass or two of porter, or 
the camphorated julep may be given ; which also failing, a dose of 
laudanum is proper at bed-time, provided there exist no considerable 
inflammatory diathesis. 



REMITTENT, OR BILIOUS FEVER. 175 

The pain in the bowels is mostly relieved by the warm bath, or 
a moderate bleeding and emollient injections ; to which, occasion- 
ally, may be added twenty or thirty drops of laudanum. If these 
produce not the desired effect, and the fundament be scalled from the 
evacuations, give clysters of milk and lime-water, composed of half 
a pint of each. These failing, inject every hour with cold water, 
and apply cloths wrung out of it, to the belly. 

If delirium come on in the first stage of the disease, it is to be 
treated by bleeding, purging, and the means prescribed above for 
violent headache; but, should it occur at a later period, the pulse 
weak and irregular, with a great propensity to sleep, besides making 
cold applications to the head, the body should be frequently sponged 
with cold vinegar and water, or equal parts of vinegar and spirits. 
And, should not the recollection in a few hours become more im- 
proved, and the pulse fuller and more uniform from this mode of 
treatment, it will be proper to apply a blister to the head, and 
sinapisms or blisters to the extremities; besides which, wine or some 
cordial must be allowed ; and if there be a cold sweat, or coldness 
of the extremities, flannels wrung out of hot spirits, or spirits of 
camphor, ought to be applied often around the arms, legs, and thighs. 

On the decline of this fever, patients are sometimes troubled with 
night sweats, to relieve which, gentle exercise in fresh air, and the 
tonic powder or pills, (see Dispensatory^) or bark and elixir vitriol 
will be proper. 

The usual fatility of this fever in Washington, as well as in many 
sections of our country, during the last summer and fall, was suffi- 
cient to create alarm, and to induce the benevolent to solicit, through 
the medium of public prints, information, relative to the most suc- 
cessful mode of treatment. 

Although the practice I pursued last autumn, did not materially 
differ from that above recommended, yet I am persuaded a brief 
sketch of the improvement, accompanied with a few remarks, will 
be gratifying to most of my readers, particularly as I can state, an 
incontrovertible fact, not a patient who was governed by my pre- 
scriptions died during the sickly season ; nor was there a case of the 
disease degenerating into the nervous, when early application was 
made. This extraordinary success was the more remarkable, as the 
nifrnber of my patients was very considerable ; in so much, that it 
was impracticable to visit all of them daily, and many were attended 
principally by my students. Some of the indigent sick would doubt- 
less have followed the fate of many of the paupers who died, had I 
not been sensible that exhibiting medicines, without paying due at- 
tention to regimen would not have the desired effect; and knowing 
this fact, I felt it my duty to those for whom I prescribed, to have 
them supplied with nourishment suitable to the case. 

In most instances, the lancet was resorted to ; and with some pa- 
tients of robust constitutions, and inflammatory dispositions, it was 
used freely in the early stage of the disease. 



176 REMITTENT, OR BILIOUS FEVER. 

Aperient medicines being of the greatest importance, were fre- 
quently administered, and I found their salutary effects evidently 
increased by conjoining such as determined to the surface. Twenty 
grains of calomel, united with a grain of tartar emetic, or six or eight 
grains of ipecacuanha, were administered to an adult in the morn- 
ing, and followed in a few hours by an ounce of Epsom salts, or an 
infusion of salts, senna and manna, in broken doses. When a pre- 
ference was given to medicine in the form of pills, I directed two of 
the aperient and diaphoretic pills, (see Dispensatory^) to be given 
every two hours, or two of them to be taken at bed time, and the 
dose repeated every hour in the morning, until several copious evac- 
uations were produced. With infants, calomel and ipecacuanha in 
large doses repeated occasionally, were often found sufficient. 

It should be observed, with respect to aperient medicines, that 
though active in their operation, they do not weaken the patient, as 
generally supposed ; for they take away the cause of at least appa- 
rent weakness; and we have often found patients in fevers taking 
bark and stimulants to support them under this apparent debility, 
who, after the operation of some laxative medicine, required neither. 
In the employment of this remedy, however, it is necessary to attend 
to the discharges. The nurses will often report frequent evacua- 
tions, and if examined, these may be found mucous and insufficient, 
or a watery fluid scarcely coloured. It is necessary that the stools 
should be truly feculent, and be continued while the discharges are 
dark and offensive. We ought, therefore, not to be governed by the 
number of evacuations ; but by the effects and the patient's feelings. 
If he be relieved after each stool, and the pulse become softer, the 
hand more moist, and the head less loaded, he need not be appre- 
hensive, however violent the discharge. On the contrary, if the 
pulse become smaller and more frequent, the face sink, and faintness 
come on, however little the discharge, it has been too much. 

In some cases, emetics were employed with very good effects. 
They greatly contributed to relieve congestion in the liver, and 
were also useful in determining to the skin as well as carrying off 
the bile. 

When purgatives were not requisite, the febrifuge mixture, dia- 
phoretic drops, or antimonial powders were administered in their 
usual doses, every two hours, with the view of promoting a gentle 
diaphoresis, and to assist their effects, the patient being directed to 
take frequent small drinks of some tepid diluting liquor. Medicines 
of this class, by exciting perspiration, will be found to produce most 
beneficial effects, in those cases where the vital energy is not dimin- 
ished ; but when considerable debility is present, they frequently fail 
of having the desired effect, and act on the bowels, producing a 
dangerous diarrhoea. When the fever manifested a disposition to 
yield, the infusion of Columbo or camomile was given, particularly 
after the immediate operation of laxatives ; which had the effect of 
correcting the bile, restoring the tone of the stomach, and supporting 



REMITTENT, OR BILIOUS FEVER. 177 

the patient's strength. And so soon as there was an intermission of 
fever, or symptoms of the disease assuming the typhoid state, the 
bark,* conjoined with Virginia snake-root, was given in such doses 
as the stomach would retain, which, together with the liberal use of 
porter and wine, and nourishing diet, speedily arrested the disease. 

In some instances the nitric acid, diluted, {see Dispensatory^) was 
employed as a tonic with considerable advantage, particularly in 
delicate habits ; or when there were symptoms indicating the liver to 
be diseased. With others, again, the solution of arsenic in the usual 
doses was administered with the most happy effects. 

The warm bath, in every instance in which it was employed, pro- 
duced beneficial effects ; and when the luxury could not be procured, 
sponging the body and extremities with vinegar and water, or equal 
parts of vinegar and spirits, afforded great relief. 

A few cases occurred of patients of robust constitutions, who not 
only neglected the proper remedies at the commencement, but ag- 
gravated the disease by taking stimulating drinks or active exercise, 
were at length attacked with great prostration of strength, accompa- 
nied with cold clammy sweats, coldness of the extremities and im- 
peded pulse. These symptoms indicated that considerable conges- 
tion had taken place, which would admit of no delay. I directed 
the warm bath, and when this could not be immediately obtained, 
friction and flannels wrung out of hot spirits, into which red pepper 
and mustard seed had been infused, were applied to the extremities, 
and renewed as often as they became the least cold. As soon as the 
natural warmth was restored, blood-letting with calomel and aperient 
medicines was resorted to ; and also blisters over the region of the 
liver and extremities. — It will frequently occur, in such cases, that 
the action of the heart is so overpowered in the first instance, that 
the blood merely trickles, or rather oozes, from the punctured vessel 
for a considerable time, being much darker and thicker than natural. 
Yet, when a few ounces have been drawn, it usually flows with 
freedom, and becomes, finally, of a brighter colour. 

The deficiency or irregularity of heat on the surface is among the 
first symptoms that indicate congestive disease ; and if the skin can 
be restored every where to its natural warmth, a cure may be ex- 
pected. It is evident the warm bath, frictions of the skin, blood- 
letting, calomel with purgatives, and blisters are the chief expe- 
dients to diminish congestion ; but unless these be very early resorted 
to, they will not succeed, so rapidly does the stage of collapse super- 
vene. Recovery very generally succeeds, if natural warmth be 
speedily restored, and a universal perspiration excited. Upon this 
principle is to be explained the repeated success of the practice pur- 
sued by some practitioners in the plague ; for immediately after per- 
sons were perceived to be affected, and, consequently, while there 
was yet no arterial excitement, they were subjected to frictions by 

* The sulphate of quinine had not at that time acquired its present celebrity. 
23 



ITS REMITTENT, OR BILIOUS FEVER. 

warm oil, in a close room, and over a brazier of hot coals, until a 
free perspiration took place. 

Some patients, in the course of the disease, were afflicted with 
acid eructations and heart-burn, but were relieved by magnesia, the 
absorbent mixture, or mucilage of gum Arabic. These medicines 
were also useful in giving check to watery evacuations, which some- 
times occurred on the exhibition of diaphoretic medicines ; others, 
again, on the decline of fever, were troubled with pain, arising from 
flatulency, which required occasionally a little mint water, ginger 
tea, tincture of asafcetida, or spirits of lavender. This symptom, 
however, seldom came on when proper attention was paid to the 
discharge of the bowels. 

In a few cases, the hiccough became exceedingly troublesome, 
but was relieved by taking in turns the syrup of damsons, a lump 
of loaf sugar moistened with brandy, tincture of asafcetida, or the 
camphorated mixture. When these failed, a cataplasm of mustard 
seed and vinegar applied over the region of the stomach generally 
succeeded. 

Strangury was another spasmodic affection that required particular 
attention. Although the occurrence of this system was frequently 
the effect of blisters, (see Suppression of Urine,) yet, in some cases, 
it evidently was produced from a spasmodic irritation of the neck of 
the blaVider. And when arising from this cause, the camphorated 
powders, the warm bath, or injections of warm camomile tea or 
infusion of hops, with laudanum, proved to be the best remedies. 

Hemorrhages sometimes occurred, and when preceded by head- 
ache, the pulse full and hard, indicating an inflammatory disposi- 
tion, recourse was immediately had to blood-letting, followed by 
aperient and diaphoretic medicines ; but when the discharge was at- 
tended with faintness, or happened at the conclusion of fever, the 
bark, elixir vitriol, or nitric acid, with cold drinks, were prescribed. 
Nitre, in doses of ten grains every hour or two, in a glass of cold 
water, as well as cold applications near the parts affected, were em- 
ployed, iu both cases, with evident advantage. 

Longings for improper food and drink, with some patients, were 
exceedingly troublesome. On the decline of fever, when this symp- 
tom did not arise from the caprice of the moment, and the patient 
anxiously craved any particular food or drink, it was allowed not 
only with impunity, but considerable advantage. 

Those cases in which I was consulted after the typhoid state of 
fever had come on, as manifested by a disturbed state of the brain 
and nervous system ; showing itself in frequent sighings, wandering 
delirium, watchfulness or irregular and interrupted sleep; charac- 
terized, also, in the more advanced stage of fever, by a deranged 
state of the secretions and excretions, attended with a brown or black 
state of the tongue, and a cadaverous and offensive smell of the 
whole body, my attention was drawn to support the patient's strength 
by supplying him with nourishing diet, and giving stimulants, both 



REMITTENT, OR BILIOUS FEVER. 179 

difFusable and permanent, as recommended under the head of Ner- 
vous Fever. 

Attention was also paid to the state of the bowels, and their offen- 
sive contents were evacuated daily, not by active purges, which, in 
this exhausted state of the system, would destroy the patient, but by 
injections, and the occasional use of small doses of calcined magnesia 
alone, or conjoined with a few grains of rhubarb. 

I was no less attentive in having the offensive materials which 
were constantly excreted by the skin, removed by wiping the body 
and extremities twice a day with a cloth wetted with equal parts of 
vinegar and spirits. Care was also taken to have the sheets and 
linen of the patient frequently changed. 

By perseverance in the means above stated, several persons, whom 
I was called to visit at the latter stage of the disease, recovered under 
the most unpromising circumstances. One case particularly deserves 
to be noticed, in order to show the impropriety of giving up a patient 
while there is life. 

Mrs. Lund Washington lingered under this disease, upwards of 
six weeks, before application was made to me, and learning she had 
been given up by her physicians as a hopeless case, I was unwilling 
to attend ; but from the earnest solicitude of her son, Mr. Peter 
Washington, I consented, provided the medical gentlemen who at- 
tended her would meet me. Prom some cause or other, neither of 
the physicians appeared at the hour appointed, and as there was no 
time to be lost, I took the liberty of prescribing in their absence. 
I found her in a state of excessive debility, and on examining her 
mouth, the tongue was covered with small white blisters, and gums 
with a foul sordes, accompanied with a cadaverous breath. Her 
bowels were in a very irritable state, and from the acuteness of pain 
she occasionally felt in them, caused her to scream out in a most 
lamentable manner. The state of her mouth readily induced me to 
ascribe the affection of her bowels to the swallowing of some putrid 
matter, and notwithstanding her extremely debilitated state, I deemed 
iPnecessaty to direct a table spoonful of castor oil to be given, and 
its operation encouraged by injections of soap-suds. At the same 
time, her strength was supported by arrow-root, made palatable by a 
plentiful addition of wine and nutmeg. I directed, also, fresh char- 
coal powder to be given in doses of a spoonful every two or three 
hours, which produced most beneficial effects, as the distressing 
symptoms soon yielded. On farther examination, I found one side 
of the hip and lower part of the back in a gangrenous state. To 
arrest this, poultices of charcoal and bark were frequently applied, 
and as soon as a bathing vessel could be procured, a strong decoc- 
tion of red oak bark prepared, she was taken up in a sheet and 
bathed daily, from thirty to sixty minutes at a time. The number 
of blisters which had been applied, together with the large ulcers in 
her back, occasioned great pain in bathing, as well as in moving her 
from one sheet to another: but, notwithstanding this, as her stomach 



180 REMITTENT, OR BILIOUS FEVER. 

would not retain a sufficient quantity of either bark or nitric acid. 
I had the bath continued about three weeks, which, together with 
the most nutritious diet and a plentiful use of wine, porter, and 
other stimulants, her general health was so far improved as to re- 
quire little or no attention except to the ulcers. These, after the 
mortified parts had sloughed ofT, were very deep and extensive, 
exposing the bone, and requiring more attention than I was able to 
give. I therefore requested the surgical aid of Dr. Bailey Washing- 
ton, and by the skill and attention of this gentleman, those ill 
conditioned ulcers were healed in a few weeks. And I am happy 
to add, this most amiable lady is now restored to perfect health, to 
the exceedingly great joy of her affectionate family and numerous 
friends. 

Regimen. — With respect to regimen, the food and drink should 
be varied, and adapted to the taste of the patient. Nature, perhaps, 
generally takes care that no error shall be committed in that way, 
during the continuance of this disease. The patient is seldom per- 
suaded to swallow any thing but liquids, during the prevalence of 
the fever ; and if by accident he should have an inclination for 
something more solid, arrow-root, sago, corn, or rice, gruel, mush, 
panado, custards, roasted apples, oranges, grapes, or other mild ripe 
fruits are all that should be allowed. To allay the thirst, barley or 
rice-water, apple-water, tamarind-water, molasses and water, toast 
and water, or cold spring water, lemonade, raspberry or currant jelly, 
dissolved in water, mint or balm tea, acidulated with lemon juice, or 
other pleasant acids, may be given with great benefit, in frequent, 
but small quantities. These cooling drinks not only quench thirst, 
but also tend to excite perspiration. 

Washing the face and hands of the patient, from time to time, 
with vinegar and water, is always refreshing. The room should be 
somewhat darkened, and kept moderately cool, by a constant suc- 
cession of fresh air; taking care, however, that the current of the 
wind be not immediately directed on the patient. The covering of 
the bed ought to be such as is found most comfortable, and the body 
kept, as nearly as possible, at rest. When the fever subsides, and 
the patient regains a desire for food, it will be best, in addition to 
the mild articles of diet already mentioned, to begin with puddings 
of various kinds, newly laid eggs, boiled soft, soups with vegetables, 
raw oysters, &c, resuming his diet gradually, as he finds his health 
return. 

To keep up the tone of the system, a moderate use of genuine 
wine, or porter diluted, or brandy, or rum and water made weak, will 
be proper; at the same time paying due attention to air, cleanliness, 
and exercise. 

Thus have I detailed, in the clearest manner, according to my 
experience, the best curative means of this, the most prevalent and 
dangerous of all our southern maladies. It is, however, much easier 
to prevent than cure diseases; and, in order to the first, I will point 






REMITTENT, OR BILIOUS FEVER. 181 

out the general means which have been found conducive to this 
great end, and which constant experience has sanctioned. 

When the symptoms are malignant, attended with coma, stertor, 
syncope, stupor, convulsions, great debility, hippocratic countenance, 
or intermitting pulse, &c, and threaten sudden death, the bark is to 
be given in large quantities. Eight or ten grains of quinine every 
two or three hours, in desperate cases may be ventured. When 
there is pain in the breast or head, the bowels should be kept open 
with calomel and jalap. And if the pulse be full and frequent, with 
apoplectic, or comatose symptoms, bleeding may be cautiously at- 
tempted. Excessive diarrhoea should be restrained from the danger 
of debility. 

Where the paroxysms are protracted, violent, and run into each 
other, or are attended with coma, these symptoms are to be relieved 
by one ounce of Epsom salts and half an ounce of bark divided into 
four portions, and one taken every two hours. If there be present, 
syncope and excessive weakness, wine and bark should be given. 
In such cases large doses are necessary : half an ounce of bark or 
seven or eight grains of quinine every two or three hours. When 
the pulse is small and hard, or obscure, and a clammy moisture on 
the skin, blisters to the head and neck will be of service. There 
are certain states of the system forbidding the use of the bark. 

These are first, an inflammatory disposition, evinced by a small, 
hard, and frequent pulse, flushed face, difficulty of breathing, pains 
in any part of the body, general fever, sizy blood, dry skin, yellow 
tongue. 

2d. It is forbidden by a deranged state of the liver, evinced by a 
pale or yellowish cast of countenance, hard and tumid belly. This 
to be treated by purgatives, chiefly calomel and jalap. 

3d. Dropsy. In this purgatives to be relied on. 

4th. Pain in the head, during the intermission. 

5th. In excessive sweats — tympanites or distension of large intes- 
tines with air. Hectic sometimes succeeds intermittents in children 
with a hard and swollen belly, cough and other consumptive symp- 
toms. To be treated by purgatives. An excessive flow of urine 
follows the ague in aged people and this is to be treated with 
bark, wine and abstinence from vegetables. When the disease is 
found incurable by the ordinary means, recourse is to be had to warm 
water alone, with no food for two or three days, taking six or eight 
pounds a day. At the end of three days, give barley water with 
burdock tea. After this gentle tonics. 

The substitutes for the bark, are the broad-leafed willow Prunus 
Virginiana. Sassafras. Persimmon. Dogwood or cornus Florida, 
(from which the sulphate of cornine has been obtained.) The mag- 
nolia grandiflora. The poplar. The boneset. The calamus, united 
with equal parts of bistort and ginger. The rhatany, in the dose 
of twenty grains of the powder, or in form of extract, or decoction. 
Charcoal one scruple three or four times a day. Sulphate of copper 



182 REMITTENT, OR BILIOUS FEVER. 

one-fourth to one-half a grain four times a day. Rust of iron and 
iron filings have been used in old cases. All these may be combined 
with bark. Arsenic has been given with great success in five drop 
doses gradually increased. Sulphate of zinc in two grain doses, three 
times a day, with a little opium one-eighth to one-fourth of a grain. 

With regard to diet, the best is the most nourishing, the least irri- 
tating, and most digestible. Rice, sago, panado, barley boiled with 
raisins or figs, apricots, peaches, prunes, apples, mutton, beef, fowls. 
Broiling is the best manner of preparing animal food. Drinks proper 
are beer, porter, port wine with water. Lamb and veal more indi- 
gestible than beef and mutton. Fish improper. Flesh of old animals 
more digestible than that of young. Vegetable substances more 
difficult than animal. Vegetables, smoked and baked meats, pastry, 
cucumbers, melons, soup, gravies, and butter, should be avoided. 

Prevention. — Bark, nourishing and stimulating drinks. Camo- 
mile, quassia or gentian tea — avoid morning, evening and night air, 
hot sun, intemperance in eating and drinking, improper food. The 
upper story of a house to sleep in preferable. Lime should be scat- 
tered abundantly around the premises. All putrid matter should be 
destroyed. Ventilation, and cleansing of houses, warehouses, ships, 
hospitals, and all places of filth, important. 

To obviate the attack of summer and autumnal fevers, we should 
intercept their causes, or guard the habit as much as possible against 
their influence. 

Therefore, on visiting a warm climate where any epidemic pre- 
vails, the first step is to prepare the system, as much as possible, for 
the unavoidable change it is about to undergo ; and this preparation 
consists in living temperately, and taking every other night, or 
oftener, one or two grains of calomel, or chewing rhubarb, or drink- 
ing molasses and water, or using sulphur in such doses as to increase 
the discharge by the bowels, without debilitating the system. If there 
prevail a fulness of habit, the loss of ten or twelve ounces of blood 
will also be a useful precaution. In the meantime an imprudent 
exposure to the heat of the sun, or night air, should be strictly 
avoided. 

Hard drinking is another cause of disease, which should be care- 
fully guarded against in warm climates, particularly by seamen, who 
of all others are, perhaps, the most inattentive to health. The same 
admonition applies to their sleeping on deck during the night, and 
cold bathing when over-heated, or in a state of intoxication, which, 
by suddenly checking the copious perspiration, seldom fails to bring- 
on disease. 

Cold, moist air is a frequent cause of disease in warm climates ; 
hence, too much attention cannot be paid to comfortable fires, and 
suiting the dress to the changes of the weather. 

Flannel worn next to the skin is one of the chief preservatives of 
health. Many people, indeed, clamour against it as tending to de- 
bilitate, because it creates perspiration. But this is altogether a sill} 



OR BILIOUS FEVER. 183 

prejudice; as mild perspiration, or a soft skin, so far from being 
hurtful, is the very habit of health. It preserves a proper medium 
of temperature, by absorbing the excessive moisture from the body 
during the day, and by preventing the effects of the cold damp air 
at night. 

Cleanliness, both in our persons and apartments, is so essential to 
health, as to form a leading consideration in all our views to that 
first of blessings. The neglect of this not only renders a man loath-' 
some and offensive to himself, but gives rise to many of our most 
inveterate and fatal diseases. 

Among the various means used for the prevention of diseases, and 
for the preservation of health in general, none, perhaps, is more 
beneficial in warm climates, than good wine, prudently used. It 
increases the circulation of the fluids, promotes both the secretions 
and excretions, and invigorates all the functions of the body. How 
much is it then to be lamented, that so valuable a cordial cannot al- 
ways be got pure ; from the avarice of selfish men, who vend, at a 
low price, tart or half-spoiled wines; and, to render them saleable, 
adulterate them with the most poisonous ingredients, so that they 
become the most insidious foes to health. 

The common red wines are most generally adulterated, and arti- 
ficially coloured, as manifested by a red sediment in the glass, as 
well as in the bottle. But the most pernicious of all adulterations 
of wine, is that of sugar of lead, or lead itself, which gives it a sweet 
taste : and, therefore, it ought to be remembered, that every wine of 
a sweetish taste, accompanied with astringent qualities, may justly 
be suspected to be adulterated with that noxious mineral. (See 
Poison.) 

When genuine wine cannot be procured, good old spirits are of 
considerable service, especially when taken in small quantities, and 
much diluted. These pleasant preventives, whether under the 
name of grog or toddy, must, in consequence of their gently stimu- 
lating qualities, be particularly beneficial to persons whose lot is cast 
in low situations and moist air. But they should never forget, that 
no where is the great virtue of self-government more necessary than 
in their use. For, if indulged to excess, they seldom fail, whenever 
a predisposition to any particular disease lurks in the system, to rouse 
it to action. 

In like manner, we must have regard to a proper regulation of 
diet, which consists in preserving the happy medium between long 
fasting on the one hand, and immoderate eating on the other. Ve- 
getables are particularly adapted to warm climates, and, consequently, 
should constitute the chief part of our diet. Sweet, oil, when pure, 
is perfectly wholesome; but rancid oil, butter, fat, or meat the least 
tainted, must be wholly rejected. 

To those of weak habit and bad digestion, much benefit will result 
from a glass of the infusion of Colombo, or camomile, or cold water, 
every morning, on an empty stomach. 



1S4 NERVOUS FEVER. 

Such are the general means of preserving health, and preventing 
diseases in a southern climate. The chief point is to avoid the ex 
citing causes, and keep the bowels always moderately lax. 



NERVOUS FEVER. 

The fevers already described, and, indeed, all diseases attended 
with a considerable degree of morbid heat, affect in some measure 
the nervous system ; but in this particular species, the nervous sys- 
tem is more immediately and more violently affected, than in any 
other. When a fever is once produced, from whatever cause, it sel- 
dom fails, by long continuance, to occasion all the symptoms which 
appear in the nervous or malignant fever. 

This fever has been described by different authors under various 
names ; the typhus or nervous fever, the slow fever, the jail fever, 
the hospital fever, the ship fever, the petechial fever, the putrid 
fever, and the malignant fever. 

The first appellation it receives from its attacking the brain, and 
from the effects it produces on the nervous system. The second, 
from the slow and gradual manner in which it sometimes comes on. 
The third, fourth, and fifth, from their being apt to arise in jails, 
hospitals, and ships, when numbers of men are crowded together, 
and when sufficient care is not taken to have such places well ven- 
tilated and cleansed. The sixth, from certain spots which some- 
times appear on the skin of the patients labouring under this disease. 
The seventh, from the putrid state, or tendency supposed to take 
place in the fluids ; and the last, from the dangerous nature and ma- 
lignity of the fever : but they are all one and the same disease, va- 
riously modified, according to the violence of the symptoms, and the 
different constitutions of the patients. 

Symptoms. — The symptoms are commonly more various in this, 
than in any other fever. It sometimes creeps on in such a slow, in- 
sidious manner, that the patient will have suffered the disease to 
make considerable progress, before he thinks it necessary to use any 
remedies. On other occasions it comes on with a great degree of 
rapidity, and with many of the symptoms common to all fevers. 

Thus, it commences with alternate sensations of heat and cold, a 
want of appetite, a nausea, and occasional vomiting. These are fol- 
lowed by some confusion of the head, a sense of weakness, dejection 
of spirits, tremour of the hands, and frequent sighing, without know- 
ing the cause. At this stage the pulse is irregular, sometimes a little 
quicker ; at other times, about the natural standard. In some, a 
dull and heavy pain, with a sense of coldness, possesses the back 
part of the head ; in others, a pain in the orbit of one eye. 



NERVOUS FEVER. 185 

These symptoms gradually increasing, the pulse becomes smaller, 
and at the same time quicker, while the arteries of the temples and 
neck beat with additional force. The patient is generally more 
restless towards night, the breathing is somewhat difficult, and very 
little refreshment is obtained, from his short and disturbed slumbers. 
This gradual increase of symptoms, with the peculiar, pale, sunk 
countenance attending fever, will give the alarm, even when other 
nervous diseases with which the earlier symptoms have been con- 
founded are present. 

In the progress of the disease, the system is equally affected; for 
sometimes headache, restlessness, and uneasiness, prevail in a high 
degree, whilst at the same time the tongue is clean and moist ; and 
at other times, while there is no headache, or restlessness, the tongue 
will be dry and foul, and profuse sweats will break out. This fever, 
moreover, is not only thus irregular, in affecting various parts of the 
body differently, but it is also irregular in its exacerbations ; and 
these instead of taking place in the evening, will arise often in the 
morning. Again, sometimes the fever is very violent for the first 
three or four days ; it then diminishes for a time, and then perhaps 
increases again. After, or about the tenth day, the weakness 
increases considerably ; the whole nervous system becomes affected 
with tremours and twitchings; the urine is commonly pale; the fin- 
gers are in constant motion; the tongue becomes dry, of a dark 
colour, and trembles when attempted to be put out ; and sometimes 
gums and lips are covered with a dark viscid substance. To these 
succeed stupor, cold clammy sweats, with a fetid smell, hiccough, 
and twitching of the tendons, together with an involuntary discharge 
of the excrements. 

In every malignant case, this fever tends fatally on or before the 
seventh day : but more frequently those who die, are carried off 
about the middle or towards the end of the second week. When 
the patient survives the twentieth day he usually recovers. When 
the fever terminates favourably before, or at the end of the second 
week, the crisis is generally obvious ; but when that happens at a 
later period, particularly if after the third week, the favourable turn 
is less evident ; and sometimes several days pass, during which the 
disease goes off so gradually, that the most experienced are in doubts 
whether it abates or not. At length, however, it becomes evident 
by a warm moisture on the skin, by the dark-coloured gluey sub- 
stance which adheres to the gums and lips, growing less tenacious, 
and being more easily removed ; by the stools regaining a natural 
colour; by the urine being made in greater quantity, and depositing 
a sediment"; by a return of appetite, and by the pulse becoming- 
slower than it was at the commencement of the disease. Deafness 
ensuing, tumours appearing behind the ears, a red rash, ami an 
inflamed scab below the nose, or about the lips, are also considered 
favourable. The symptoms which point out the near approach of 
death, are a change of voice, a wild stare, a constant inclination to 
24 



186 NERVOUS FEVER. 

uncover the breast, purple or livid spots on the skin, laborious respi- 
ration, profuse evacuations by sweating or purging, much watchful- 
ness, sinking of the pulse, great incoherency of ideas, muttering, 
picking at the bed-clothes, considerable dilatation of the pupil of the 
eyes, involuntary discharges by urine and stool, starting of the ten- 
dons, hiccoughs, and convulsions. If many of these symptoms 
occur, little expectation of recovery can be entertained. 

Dilated pupil, a glassy, staring eye, involuntary, cadaverous, smel- 
ling evacuations, hiccough, cold, clammy and partial sweats, with a 
small weak, creeping, and tremulous pulse, anxiety, restlessness, and 
greasy colour of the face, or a sad expression, low muttering, or high 
delirium, starting of the tendons, quick speech, voice altered, con- 
stant watchfulness, with incoherence, stern sullenness, or unmanage- 
able fury of mind, picking of the bed-clothes, blindness, inability to 
put out the tongue, difficult deglutition, sliding down in the bed, 
lying on the back, drawing up the knees, insensibility, with a dis- 
position to uncover the breast, or frequent attempts to get out of bed, 
denote the approach of death. 

Causes. — This fever is occasioned by impure air, putrid animal 
and vegetable effluvia, innutritious diet, and by living on damaged 
provisions. We are, therefore, not surprised to find it often originate 
in jails, ships, and dirty dwellings, where numbers are crowded 
together, and where it is not possible to have sufficient ventilation. 

Though human contagion, and the effluvia arising from putrid 
animal and vegetable substances, are the most frequent and active 
causes of this disease, yet they cannot be considered as the only 
ones; for we sometimes meet with instances in a country neigh- 
bourhood, of persons being seized with the disease in all its malig- 
nity, where it is not epidemic ; nor can it be traced to any place 
where the human effluvia could be supposed to be confined in any 
uncommon degree. 

Hence nastiness, a moist atmosphere, much fatigue, cold, depress- 
ing passions, scanty diet, excessive study, too free use of mercury, 
immoderate venery, profuse hemorrhage, or whatever weakens the 
nervous system, may be enumerated among the causes. 

Treatment. — With regard to the cure, when the inflammatory 
symptoms appear to run very high, the early use of the lancet will 
be required. It should be observed, however, if blood-letting be 
employed in all the various forms of typhus, without due regard to 
the period of the disease, the quantity of the blood drawn, the age, 
habit, and constitution of the patient, it will often be followed by 
fatal consequences. On the contrary, if it be cautiously used in the 
beginning of the inflammatory typhus, it will be of the greatest 
utility, as it will render the other means more prompt and effectual, 
and thereby facilitate the cure. 

When the lancet is resorted to, the blood should be taken away 
in small quantity, and from a small orifice. And as the rising of 
the pulse, under bleeding, is a certain indication of its propriety, so 



NERVOUS FEVER. 187 

its sinking is as certain an indication of its impropriety ; hence we 
have a criterion to guide us in the operation. Towards the close of 
most acute fevers of severity, there is some tendency to a change in 
the constitution of the fluids; and this may occur as soon as the 
second or third day, in the most malignant cases of typhus. The 
blood, when drawn in this state, loses its florid colour, and as it 
flows from the arm, exhibits a dirty, dark appearance, sometimes of 
a muddy blue, and sometimes of a deep black. It does not coagu- 
late, but continues in a dissolved state in the vessel, which induced 
the ancients to call it putrid. It is unquestionably very unfavoura- 
ble, and indicates that depletion is improper. 

In general it will be the safest to resort to the evacuation of the 
alimentary canal; therefore, on the first appearance of the symptoms, 
twenty or thirty grains of ipecacuanha, or four or five grains of tartar 
emetic, may be dissolved in a pint or more of weak camomile tea ; 
of which the patient may drink a gill every fifteen or twenty 
minutes, until it excites vomiting, which ought to be assisted by 
drinking freely of warm water : or should any costiveness prevail, 
give a dose of calomel alone, or conjoined with ipecacuanha, and 
in a few hours afterwards, some rhubarb, Epsom salts, or infusion 
of salts, senna and manna, in broken doses, to evacuate the bowels 
of their morbid contents. Through the whole course of the disease, 
the bowels must be kept in a soluble state, either by some of the 
above medicines or acid laxatives, as cream of tartar and tamarinds, 
by fruits, or by clysters. Two or three stools daily may be safely 
borne, though if so great an evacuation should appear to debilitate, 
even this number should be curtailed. However, the patient should, 
in no case, be more than two days without a stool, for a great deal 
of feculent matter is produced in fever, although little food is taken, 
and costiveness is apt to induce an increase of heat and affection of 
the head, as delirium, &c. In administering purgatives, care must 
be taken not to employ them in such doses as would operate very 
copiously, as great debility might thereby be produced. So long as 
the alvine evacuations continue of a dark colour or unnatural ap- 
pearance, calomel should be given not only as an aperient, but also 
with a view of producing ptyalism. The alterative operation of this 
medicine, in the early stage of the disease, is a circumstance highly 
to be desired, as it equalizes the circulation, and diminishes visceral 
congestions. In typhus proceeding from contagion and of a malig- 
nant nature, very few hours should be lost in these preparatory 
steps; for the disease often hastens with rapidity, and the worst 
symptoms sometimes occur, as early as the fifth day. 

In the early period of the simple typhus giving an emetic, followed 
the next day by some active purgative medicine, have frequently 
cut short the fever at once ; and when this desirable effect has been 
produced, they have hardly ever failed to shorten its duration, and to 
lessen its danger. 

Although medicines, which might excite profuse sweating, woiHd 



188 NERVOUS FEVER. 

be highly improper in this fever, yet those possessed of a mild, dia- 
phoretic power, as Dover's powders, the camphorated powders or 
mixture, (see Dispensatory ,) the spirits of nitre, or infusion of Virginia 
snake-root, may be occasionally employed with advantage. 

The saline mixture given in a state of effervescence, every two 
hours, readily abates thirst, and removes the increased irritability of 
the system. In like manner, a table- spoonful of yeast, given every 
three or four hours, affords much relief, and has, alone, often proved 
an effectual remedy. 

The Rev. Edward Cartwright, having read of the power of fixed 
air in preserving meat from putrefying, was induced to make trial of 
yeast on a boy of fourteen years of age, who had been ill several 
days of a putrid fever, for which bark and wine had been exhibited 
without any apparent advantage, and where there was but little hope 
of recovery. He directed two table-spoonfuls of yeast to be given 
every three hours, which having been complied with, the boy found 
almost immediate relief, and recovered very quickly. Mr. Cartwright 
reports, that he gave the same remedy to above fifty patients in this 
fever, without losing one. 

Whatever may be the mode of action of yeast in typhus, the fact 
appears to be indisputable, that fixed air takes off that extreme de- 
bility of the stomach so conspicuously marked in disorders of this 
nature ; and in proportion as that subsides, the pulse rises, becomes 
slower and fuller, the burning heat on the skin disappears, and a 
truce is gained for the reception of nourishing supplies. The most 
agreeable mode of administering yeast, is to add two table-spoonfuls 
of it to a quart of beer or mild porter, of which a wine glassful may 
be taken every hour or two. 

According to the practice of Drs. Thomas, Currie, and Jackson, 
as well as other eminent practitioners, the affusion of cold water is 
one of the most powerful and efficacious means which we can make 
use of in typhus fever. Its effects will be more salutary, in propor- 
tion as it is early adopted ; that is, during the first stage of the disease. 
Such being an indisputable fact, established upon the firmest basis, 
we ought always to employ it, very soon after we have evacuated the 
contents of the alimentary canal. In the early stage of the disease, 
cold water may be poured in considerable quantity from a height, or 
dashed forcibly from a pail on the patient. But aspersion or ablution 
of the body, by means of a sponge, will be more eligible and safe in 
the advanced periods. The effects produced by both modes are 
grateful and refreshing to the patient, and they usually bring about 
an abatement of fever, followed by more or less of a diaphoresis, and 
tlxis again by a refreshing sleep. 

Dr. Currie states, that the cold affusion may be used at any time 
of the day when there is no sense of chilliness present ; when the 
heat is steadily above what is natural ; and when there is no general 
or profuse perspiration. During the cold stage of the paroxysm of 
fever, while there is any considerable sense of chilliness present, or 



NERVOUS FEVER. 189 

where the body is under profuse sensible perspiration, this remedy 
ought never to be employed, as by so doing we might extinguish 
life. In the advanced stage of fever, when the heat is reduced, and 
the debility great, some cordial, such as wine warmed, with an ad- 
dition of spice, or even brandy, should be given immediately after it. 

When recourse is had to this remedy, every arrangement should 
be made for the affusion before the patient is moved at all, and fatigue 
as well as disgust should be avoided as much as possible. In those 
cases where the delicacy of the system, or the apprehensions of the 
patient or of the by-standers, may prevent cold affusion from being 
employed, we may substitute tepid affusion for the more powerful 
remedy, or we may recommend either ablution or aspersion. The 
tepid affusion, the water being lukewarm, or from 87 to 97 degrees 
of Fahrenheit, produces a cooling effect equal to that of cold affusion ; 
Dartly in consequence of a more speedy evaporation, and partly be- 
cause so great a glow or reaction does not succeed. The important 
object of diminishing heat, therefore, may be obtained with great 
certainty by the repeated employment of the tepid affusion, suffering 
the surface of the body to be exposed in the interval to the external 
air. A diminished frequency of the pulse, and respiration, and a 
tendency to repose and sleep immediately ensue, though its effects 
are not so permanent as those of the cold affusion. 

Doctor Currie reports, that a putrid fever having made its appear- 
ance in a regiment quartered in Liverpool, he had the men drawn 
up and examined, seventeen of whom were found with symptoms of 
it upon them — these he subjected to the cold affusion once, and 
sometimes twice a day. In fifteen of this number, the contagion 
was extinguished, and in the remaining two the fever went through 
its sourse. The healthy part of the regiment bathed in the sea^ 
daily, and by these means, he effectually destroyed the contagion 
He farther relates, that of thirty-two who went through the disease, 
by its being too confirmed to be removed at the time of his first 
seeing them, only two died ; and with these, recourse was not had 
to the cold affusion. 

The same remedy has likewise been successfully employed b} r 
Dr. Currie, and many others in the more advanced stage of the fever, 
so as seldom to fail of procuring a safe termination. He relates the 
case of a soldier who was in the ninth day of the disease when he 
first saw him, his pulse was 100, and feeble, his heat was 104, his 
thirst very great, his tongue foul and black, his mind much confused, 
and at times he was delirious, and petechias were dispersed over his 
whole body. The mode of treatment was as follows: his strength 
was directed to be supported by administering a bottle of wine a 
day, with an equal quantity of gruel ; every night he took an opiate 
draught, and his body was kept open by laxative clysters, and when 
these failed, by a few grains of calomel. A bucket- full of salt water 
was directed to be thrown over him immediately, which was to be 
repeated according to circumstances. 



190 NERVOUS FEVER. 

The effect was, that in a few minutes after the affusion, the heat 
lessened to 98, the pulse moderated to 96, and his mind became 
more calm and collected. Two hours afterwards he had relapsed 
nearly into his former state, but the night was passed with greater 
tranquillity. The whole of this practice was continued with nearly 
the same result, until the twelfth day of the disease, the affusion 
having been performed in the evening, and occasionally at noon. 
The fever continued its usual period ; but on the twelfth day, the 
heat having sunk to its natural standard, the cold affusion was 
thenceforth omitted, and instead of it the body was sponged all over 
once or twice a day with vinegar. 

A memorable instance of the good effects of cold affusion came 
under my immediate knowledge some years ago, says Dr. Thomas, 
whilst I practised in the West Indies. A professional gentleman of 
my acquaintance, residing in the Island of Nevis, was attacked with 
this fever ; and it proceeded with such violence, that in a few days 
petechia appeared on different parts of his body, and a hemorrhage 
of blood issued from his nostrils, mouth, and other places. Under 
these unfavourable circumstances, he was freely exposed to the open 
air, and one or two buckets of cold water were thrown over him ; he 
was then wiped perfectly dry, and replaced in his bed ; which plan 
of proceeding was repeated twice and sometimes thrice a day. By 
means of this application, the administration of an opiate at night, 
and a liberal allowance of wine, his life was preserved to the great, 
but pleasing astonishment of all his friends. 

The affusion of cold water on the surface of the body, is considered, 
by Dr. Jackson, as a power which makes a strong and general im- 
pression on the system, and which arrests the disease, or changes 
its condition in virtue of that impression ; but not by subtracting in- 
creased heat, as supposed by Dr. Currie. Indeed, the good effects 
of the remedy in question, cannot, we think, be wholly owing to the 
mere subtraction of heat ; for it has been used with great advantage 
in many cases of fever, where there has been no perceptible increase 
of temperature, and where, by affusion, ablution, or aspersion with 
cold water, the disease has been cut short abruptly, as well as in 
those where it had risen to a high point. Therefore, we may safely 
infer, that cold affusion, or the suddenly pouring cold water over the 
whole surface of the body, operates as a powerful stimulant, although 
its effects probably are of short duration, unless frequently repeated; 
they are produced by the suddenness of the application affecting the 
nervous energy, and by the shock rousing the dormant susceptibility, 
so as to induce a new action, as it were, of the nervous system, re- 
moving spasmodic contraction of the extreme vessels on the surface, 
carrying off a large portion of morbid heat by general evaporation, 
and the remainder by insensible perspiration ; thence restoring the 
healthy action of the exhalents and capillaries. 

As the danger of this fever is in proportion to the debility, the 
great point is to support the patient's strength and spirits by a liberal 



NERVOUS FEVER. 191 

use of tonics and cordials, which should be early employed. At the 
same time, a nourishing diet should be used, suited to the taste of 
the patient, and the most rigid attention paid to cleanliness and to a 
free circulation of pure air. In having recourse to these means, 
with a view of supporting the vital energy, we must take care to 
prevent the feculent matter from being confined, by occasionally 
administering laxatives or clysters. 

The sulphate of quinine excels all other tonics in this variety of 
fever. It should be given in the usual doses, either in pills or solu- 
tion, {see Dispensatory,) and repeated as often as the urgency of the 
case requires. Should the quinine not be at hand, the Peruvian 
bark may be given as freely as the stomach will bear, either in sub- 
stance, decoction, or infusion. The beneficial effects of the bark, 
may be increased by conjoining it with the snake-root, in proportion 
of one ounce of the former to two drachms of the latter, or by adding 
to each ounce of the bark, a scruple of camphor. Where the quinine 
is used the snake-root may be given in infusion. {See Dispensato- 
ry, under the head of Diaphoretics.) When the bark is rejected in 
its various forms, as it frequently is, we should not despair of finding 
a succedanium as long as our country abounds with the red and 
black oak. From my own observations in practice, frequent bathing 
in a strong decoction of the bark of either will produce the same 
salutary effects, as could possibly be expected from a free exhibition 
of the Peruvian bark internally. {See Materia Medica — and also 
Bilious Fever.) 

The other tonics of most efficacy in typhus are the mineral acids 
I have myself employed the nitric acid diluted, {see Dispensatory,) 
in doses of a wine glassful every two or three hours, with very bene- 
ficial effects. Dr. Thomas speaks highly of the muriatic acid in all 
febrile diseases of malignant nature. In all such cases, he says, it 
will be found a powerful and efficacious medicine. His usual plan 
of administering it is nearly as follows : — Having relieved the stomach 
by a gentle emetic, where nausea prevails, cleared the bowels of their 
feculent contents by a moderate dose of calomel and jalap or rhu- 
barb, and subjected the patient to cold affusion when the circum- 
stances already noticed have admitted of it, he gave to adults ten or 
twelve drops of the muriatic acid, guarded with five drops of lauda- 
num, in an infusion of Columbo, Virginia snake-root, or bark, and 
repeated the dose every four hours, gradually increasing the quantity 
to eighteen or twenty drops, or more. He says, from using it. in this 
manner, his practice has been attended with the most decided suc- 
cess. Dr. Thatcher, also, bears testimony in favour of this remedy. 
He states a case of putrid fever, attended with extreme danger, in 
which he administered the muriatic acid in a strong decoction of 
thoroughwort, with a few drops of laudanum. When it had been 
taken freely for about twelve hours, a profuse sweat ensued, of a yel- 
lowish colour, and nauseous smell ; a favourable change immediately 
appeared, and the recovery was rapid. 



192 NERVOUS FEVER. 

Dr. Armstrong states, that he has employed the muriatic acid in 
typhus, with beneficial effects, when it did not excite griping pains 
or diarrhoea. He has prescribed as much as two drachms of it, 
largely diluted with water, in twenty-four hours, so as to make it a 
sort of common drink. 

Another tonic of considerable efficacy in fevers of a malignant 
nature, is the solution of arsenic. Dr. Ferrier found, in the last stage 
of typhus, when neither bark, wine, or brandy, cold bathing, or even 
occasional doses of Cayenne pepper, had the effect of rousing the 
powers of life, or of lessening the thick crust which covered the 
tongue, that most singular advantages were obtained by giving the 
arsenical solutions. As soon as the febrile paroxysms are stopped, 
he considers it best to suspend the use of the arsenical solutions, and 
to support the patient with bark and different cordials. Dr. Thomas 
corroborates the efficacy of this medicine, in stating a severe case of 
typhus which fell under his care ; the patient having suffered two 
relapses of the fever, and her life despaired of, when he was induced 
to make use of this mineral solution. Its effects exceeded his ex- 
pectations, for the woman's life was apparently preserved by it. 
The solution of arsenic may be given in its usual doses every three 
or four hours. 

Of every other medicine, cordials only would supersede the bark ; 
and with these putrid fever is sometimes successfully conducted, 
when the bark is disagreeable or rejected. The chief is wine, which 
it is often necessary to give in large quantities. It must be recol- 
lected, however, that wine is an indirect stimulant, followed by a 
narcotic effect ; so that when we begin, we must continue its use 
until nature can exert herself. In this case, and in all instances of 
putrefaction, whether general or local, our remedies are intended to 
supply the powers of nature. When these are roused, our exertions 
mav be safely remitted ; and we find that this effect is produced in 
general fever, when the pulse becomes fuller and softer, the eye 
more quick, the skin more clear, and the tongue more clean and 
moist; in partial gangrenes by a beginning suppuration of the 
mortified part. 

It is impossible to fix the precise quantity of wine that ought to be 
given, as it must be varied according to the nature of the existing 
symptoms, the age, constitution, and previous habits of the patient. 
Madeira is unquestionably preferable to every other wine, but, un- 
fortunately, it is seldom to be procured genuine from the retail stores ; 
consequently, it is better to obtain the Sicily, dry Sherry, Lisbon, or 
Teneriffe wine. These should not only be given at first diluted, 
but in small portions at a time. A mixture of wine and milk, in 
proportion of one part of the former to three or four of the latter, 
constitutes an excellent drink, as well as diet, in the advanced stage 
of typhus. When the stronger wines excite too much, the weaker, 
such as claret, may be tried ; and if these should not answer, small 
repeated draughts of brisk ale or porter, may be given, and in many 



NERVOUS FEVER, 193 

cases with more salutary effects than wine ; either being calculated, 
in the last stage of typhus, to give that degree of vigour to the sys- 
tem, requisite to remove those partial congestions which often exist 
at that period in combination with general debility. Good cider is 
another substitute for wine ; and brandy, rum, or whiskey, may, 
though with less decided success, supply the place of either. 

Although stimulants are indispensably necessary, where there is 
a loss of tone in the vascular system, and real debility existing, yet 
to employ them inconsiderately, will often be attended with bad 
consequences. 

Dr. Armstrong obseives, that it would be quite as rational to give 
a half intoxicated man a tolerably free allowance of ardent spirits, 
with a view to make him sober again, as to attempt to restore, while 
the stage of excitement continues, a typhus patient, by the adminis- 
tration of wine ; for he may be said to be, in some degree, intoxicated 
by the stimulus of the fever, and he will, therefore, be more affected 
by every glass of cordial that is administered. Dr. Potter, also, ju- 
diciously remarks, that the prescribing of diffusable stimuli in every 
fever that has the name of typhus attached to it, is one of the greatest 
absurdities and strongest infatuations that infest the practice of 
physic. There is no fever that will bear, much less require, such 
agents to remove it in its first stage. 

It should be remembered, that when strong stimulants are incau- 
tiously administered, they have a powerful tendency to produce 
inflammation or congestion in the visceral organs, and thus to render 
the chance of recovery, at the best, very doubtful. Therefore, it is 
important in administering wine, or any other stimulant, to give it at 
first sparingly, and notice its effects carefully. If on trial the patient 
sleep well, breathe easily, and feel a universal glow, we may safely 
go on with it ; but if, on the contrary, it produce restlessness, diffi- 
culty of breathing, the tongue becoming drier, and the pulse more 
tense and rapid, its farther use should be omitted until the inflam- 
matory diathesis be removed. In habitual drunkards, the stage of 
collapse sometimes rapidly supervenes, and they should always have 
an earlier and more liberal allowance of stimulus, than those who 
have lived in an abstemious manner, otherwise they will sink under 
the evacuations which may be indispensably necessary to remove 
the disordered condition of certain organs. 

By this general plan, a cure will, for the most part, be effected ; 
but in the progress of the disease, particular morbid symptoms will 
require especial treatment. Thus, affections of the head, with stupor 
and delirium, will sometimes be relieved by frequently washing the 
temples with cold vinegar and water ; and occasionally bathing the 
feet in warm water. But if these affections, notwithstanding, should 
continue, it will be necessary to shave the whole of the head, and 
apply cloths wrung out of cold vinegar and water, which should be 
frequently renewed ; and if the delirium be accompanied with wit- 
ness of the eyes, a blister must, be applied to the head. 
25 



194 NERVOUS FEVER. 

Where there prevails any unusual coldness in the lower extremi- 
ties, recourse must immediately be had to the warm bath, or to some 
warm stimulating applications externally, as well as the exhibition 
of stimulants internally, in order to restore the circulation to the 
surface. The efficacy of the bath will be greatly increased, in such 
cases, by having it strongly impregnated with salt, and the patient 
should remain in it, till his skin become warm ; and on being re- 
moved to his bed, he should be well rubbed all over with hot flannels, 
and bottles of hot water, or heated bricks with vinegar poured upon 
them and enveloped in flannel applied to his feet, legs, and under 
the armpits. When a bathing vessel cannot be procured, use, as an 
embrocation, a strong solution of table salt, in heated spirits, which 
admirably recalls the languishing circulation to the surface. 

A depression of the animal heat will sometimes come on in the 
collapse of typhus without any apparent cause. The pulse becomes 
very small, and the extremities very cold ; and if some warm cordial, 
as mulled wine, hot toddy, or ginger tea, sweetened, with the addi- 
tion of a little spirits, be not immediately administered internally, 
and warm stimulating applications applied externally, death will 
soon follow. Blisters, as well as sinapisms in such cases, have fre- 
quently been employed, and are serviceable by their stimulating 
effects ; but they should not be continued on long at a time ; and 
when a blister is raised in this disease, the sore should be frequently 
washed with an infusion of red oak bark ; and nothing ought to be 
applied to the part which may tend to increase the discharge : for 
that, by debilitating the system, would prove injurious. 

If nausea or vomiting continue, apply flannels, wrung out of hot 
spirits, in which red pepper or mustard seed has been steeped, to the 
stomach and lower extremities. These failing, give the saline or 
camphorated mixture, and. apply a poultice of mint leaves or cloths 
moistened with laudanum and camphorated spirits, to the stomach, 
and cataplasms of mustard seed and vinegar to the feet. 

A slight purging, attended with a gentle moisture of the skin, not 
unfrequently arises towards the close of this fever, and now and then 
assists in carrying it off : but where it does not seem to produce a 
critical effect, it ought to be stopped as speedily as possible by giving 
charcoal or the absorbent mixture, with a few drops of laudanum, or 
by clysters of starch, or the decoction of red oak bark, containing in 
each a tea-spoonful of laudanum. When the purging is not consid- 
erable, wine or brandy mulled up with spice, or a free use of arrow 
root, with plenty of nutmeg, or rice milk with cinnamon boiled in it, 
is often sufficient. 

If purging be produced from swallowing putrid matter, give a 
small dose of castor oil or rhubarb and magnesia, and afterwards 
charcoal. (See Bilious Fever.) In the stage of excitement, a 
diarrhoea accompanied with bloody stools sometimes occurs, indica- 
tive of either a preternatural fulness of the liver, or inflammation of 
the mucous membrane of the bowels. In this case we must resort 



NERVOUS FEVER. 195 

to the warm bath, mucilaginous drinks, and evacuants, as calomel, 
and castor oil. 

It not unfrequently occurs, that patients, kept in very close apart- 
ments, have, on the approach of the last stage, black, bloody stools, 
without any offensive odour. About the same time petechial or 
purple spots begin to show themselves upon the extremities, which 
at first are only few in number, and appear as if drops of black ink 
had been allowed to dry here and there upon the skin : but becom- 
ing numerous, they soon spread over different parts of the body, and 
are generally accompanied by discharges of blood from the nostrils, 
mouth, bladder, or bowels. When these symptoms are accompanied 
with a weak, quick, thready pulse, we may be sure the stage of col- 
lapse is at hand. In such cases, recourse must be had to the most 
powerful antiseptics, such as vegetable and mineral acids, yeast, 
liquors in a state of fermentation, quinine, wine and bark, and aro- 
matics with very small doses of laudanum. At this momentous 
crisis, bathing the patient frequently in spirits, or in a bath composed 
of equal parts of whiskey and decoction of red oak bark, with a free 
admission of air, will not fail to produce good effects. In addition 
to this mode of treatment, when the hemorrhage proceeds from the 
nose, mouth, or ears, it is advisable to make use of local applications, 
as lints dipped in a solution of alum, or blue vitriol, or some powerful 
styptic. 

Miliary eruptions sometimes appear as the crisis to this fever, and 
ought, therefore, on no account to be checked by any kind of evacu- 
ations ; nor should the patient, on the contrary, be kept too warm 
with a view of forcing them out. 

Profuse sweats are to be obviated by sponging the body and ex- 
tremities daily with equal parts of vinegar and spirits; by being 
lightly covered with bed clothes ; by admitting fresh air freely into 
the chamber, and by giving whatever he drinks, cool, and agreeably 
acidulated with lemon juice or elixir vitriol. 

If hiccoughs or starting of the tendons supervene, it will be neces- 
sary to give camphor and volatile sal-ammoniac in large doses, with 
the warmest cordials. 

In cases of retention of urine, the treatment must be varied ac- 
cording to circumstances. In some instances the kidneys become 
inflamed, and in this state very little urine is secreted, until the 
healthy action of the vessels be restored by administering calomel 
and mild purgatives, swallowing freely of demulcent drinks, and, 
occasionally, using the warm bath. In the low typhus, the kidneys 
are rendered incapable of performing their functions from a loss of 
tone, and in such cases stimulants and tonics, with cold applications 
over the region of the bladder, as cloths wrung out of spirits, or 
equal parts of vinegar and spirits, are the best remedies. When the 
bladder is over distended, or inflamed, indicated by acute pain and 
some tumour, the catheter is indispensably necessary to draw off the 
water. In febrile complaints, it will be found that, where a small 



196 NERVOUS FEVER. 

quantity of urine is secreted, the sediment is proportionally copious ; 
and, on the contrary, where a large quantity is secreted, the sedi- 
ment is proportionally scanty. If attention be paid to keeping the 
bowels open from the commencement of fever, a suppression of urine 
will hardly ever take place. 

In an advanced stage of the disease, it sometimes happens, that 
in addition to a profuse secretion of viscid saliva, little white ulcers, 
or apthse, appear in the mouth. In such cases the detergent gargle, 
(see Dispensatory,) should be frequently employed, and the mouth 
occasionally washed with a solution of alum in water, an ounce of 
the former to a pint of the latter, and this will quickly take away 
the stench that arises from them. The viscid phlegm, which col- 
lects about the tongue and teeth, may be wiped away with flannel, 
dipped in vinegar, or salt and water, or after washing the mouth 
with sharp vinegar or some austere acid, it may be scraped off with 
a knife, or a piece of bent whalebone. 

From want of sleep, much rambling and low delirium sometimes 
occur, which will require an opiate at early bed -time. The most 
advisable way of giving it, to prevent any deleterious effects, is to 
conjoin laudanum, with the camphorated mixture, or the opium 
with a few grains of camphor, volatile sal-ammoniac, or some mild 
diaphoretic, as Dover's powder. Opiates are more admissible in 
this fever than in any other, and, as it is of the utmost consequence 
to procure rest, they should, with this view, be employed every 
evening, where there is no great delirium. In all fevers where we 
wish to procure sleep, and cannot have recourse to opium, on ac- 
count of delirium being present, a pillow of hops laid under the pa- 
tient's head, has been used with a singular advantage. 

In case of watchfulness, the camphorated julep, or porter and 
water will generally succeed. When, however, these means fail, 
and there is great prostration of strength, followed by stupor, and a 
train of the most distressing symptoms, wine should be exhibited in 
large quantities, and it will be found that the patient will show a 
relish for this valuable cordial, after refusing medicines and every 
kind of nourishment in a solid form. At first it is better relished 
mulled ; but afterwards the patient will take it freely in its pure 
state, and in the quantity of one or two quarts a day, without intoxi- 
cation. The quantity of wine should be regulated by the degree of 
debility present, the age of the patient, and the effects produced by it. 

The proper rule to be observed in the use of wine, is to give it 
until the pulse fills, the delirium abates, and a greater degree of 
warmth returns to the extremities. And upon the smallest appear- 
ance of the stupor returning, the pulse quickening, and sinking, foi 
they usually go together, the wine must be resumed, and continued 
in that quantity which is found sufficient to keep up the pulse, and 
ward off the other bad symptoms. 

When wine cannot be had, rum or brandy diluted with milk or 
water sweetened, will answer; and with some patients is better 



NERVOUS FEVER. 197 

relished. The friends of the sick should never be disheartened too 
soon, for here, if any where, we may say, " where there is life, there 
is hope." And I can truly aver, that I have often seen the patient 
raised, as it were, from the dead, by the determined use of generous 
wine alone, especially old Madeira. 

As soon as the patient is able to take nourishment, such as panado, 
arrow-root, &c, the quantity of wine must be gradually diminished. 
For although it be absolutely necessary to take it so liberally, during 
the continuance of this fever, yet, as soon as that shall have left 
the patient, much caution becomes necessary in the use of it ; since 
the third part of what formerly had proved a salutary cordial and re- 
storative, would in this state of convalescence, occasion a dangerous 
intoxication. 

It sometimes happens, at the close of typhus, that the patient is 
affected with a slight degree of mania or temporary alienation of the 
mind. In such case it will be necessary to support the patient with 
a generous, nutritive diet ; to keep him as quiet as possible ; and to 
give him tonic medicines, as bark and elixir vitriol, nitric acid or 
tincture, or rust of steel, carefully avoiding evacuations. 

If the appetite does not readily return on the cessation of the fever, 
the mineral acids, or stomachic bitters, will be proper. Bathing 
daily in a strong decoction of red or black oak bark, will be found 
an excellent remedy in removing the irritability and weakness which 
are left behind; and when there is no visceral obstruction, the shower 
bath will be attended with beneficial effects. 

We repeat, it is of the utmost importance throughout the whole 
course of the disease, that the most rigid attention be paid to cleanli- 
ness, and the communication with the external air be kept up in dif- 
ferent degrees day and night, according to the state of the atmosphere. 
None but those whose business it is to attend to the sick, ought to be 
allowed to go near the patient, except when there is little or no affec- 
tion of the head. In such cases the presence of a friend may sooth 
the mind and help to dispel gloomy ideas; by comforting the patient 
with the hope of a speedy recovery, and diverting his thoughts 
from that anxiety and dread of danger which invariably attends this 
complaint. 

Regimen. — In addition to the mild articles of diet enumerated in 
the bilious fever, bread and milk, with a little water, sugar, and the 
pulp of a roasted apple, form a most grateful and nutritious food ; 
and, for the sake of variety, cider, porter, or any other drink which 
the patient covets, should always be allowed. 

It has been observed, that this fever often originates from cor- 
rupted air, and, of course, must be aggravated by it ; great care 
should therefore be taken to prevent the air from stagnating in the 
patient's chamber. When that is small, and cannot be well venti- 
lated, the patient should be carried into the open air, and allowed to 
sit there two or three hours every day in mild weather. When this 
cannot be conveniently done, every means in our power to ventilate 



198 NERVOUS FEVER. 

the room should be employed. Strong-scented herbs ought every 
day to be strewed about the room, and vinegar frequently sprinkled 
about the bed-clothes, and some evaporated, by pouring it on hot 
iron. The bed-clothes ought to be in no greater quantity than is 
agreeable to his feelings, and when he can sit up, with his clothes 
loosely put on, it is often a refreshing change of posture and situa- 
tion. The patient should have his linen and bedding changed often, 
and the stools removed as early as possible ; for nothing refreshes the 
sick more than cool air and cleanliness. 

In the early stage of this disease, when there is much preternatural 
heat, washing the face and hands often in cold vinegar and water, 
and wiping the body with wet cloths, will be highly refreshing; and 
in the more advanced stage of the disease, when there is less febrile 
heat, the vinegar should be united with an equal quantity of spirit. 
In all cases where the fever is unusually protracted, and leaves the 
patient in excessive weakness, the recovery is slow and precarious, 
and the greatest care is required to prevent any error in diet, during 
the convalescence, as a very small degree of excess at this time, will 
produce veiy troublesome consequences. Food of easy digestion, 
taken in small quantities, and often repeated ; gentle exercise, when 
the weather is favourable ; attention to prevent costiveness, by some 
mild laxative ; and the use of bitters to assist digestion, or the rust 
of steel, when there is any prevailing acid on the stomach, are the 
most certain means of reinstating health. 

Contagion. — Having in the preceding chapter enumerated the 
different means for the prevention of diseases, I shall now point out 
such as are most suitable to arrest the progress of contagion when 
commenced. 

When a contagious fever makes its appearance, the first precaution 
is to separate the sick from the healthy, and thus to cut off, as much 
as possible, the intercourse between them. The next step should be, 
to purify both beds and clothes from every particle of filth. The 
chambers must be often fumigated, by burning good sharp vinegar 
or tar, and the floor washed daily with lye, or the solution of potashes, 
or strong soap-suds. A cloth wetted in lime-water and hung up in 
the room, and replaced as often as it becomes dry, is also a great 
mean of purifying infected air. 

When a contagious disease originates on ship-board, quick-lime 
should always be added to the water which is used for common 
drink, in the proportion of one pound of quick-lime to a hogshead 
of water ; but if the water be impure, a larger quantity of lime will 
be necessar) 7 ; and some of it should be put also into the ship's well, 
to prevent the putrid and foul air arising thence. 

When these means are ineffectual to stop the progress of any 
contagious disorder, fumigation with the nitrous vapour, will un- 
doubtedly succeed ; and the method of preparing it, is to put half 
an ounce of vitriolic acid into a cup, warm it over a shovel of coals, 
adding to it, by little and little, about the same quantity of powdered 



NERVOUS FEVER. 199 

saltpetre, and stirring it occasionally with a slip of glass, as long as 
the vapour arises. The vessel is then to be carried about the room, 
the doors and windows being close shut, and put in every corner and 
place where it can be suspected there is any foul air; the fumigation 
to be continued for one or two hours every day, or oftener, until the 
contagion shall be destroyed. 

If the vapour should irritate the lungs, so as to excite much 
coughing, fresh air should be admitted, by opening the door or win- 
dows of the room. However, after a little familiarity with it, this 
vapour will not offend the lungs, but on the contrary will prove 
highly grateful and refreshing. 

The vapour of muriatic acid has also been successfully employed 
in purifying infected air, and destroying contagion. It is made use 
of in the following manner. Put one pound of common salt into an 
earthern vessel, and pour over it, from time to time, a small quantity 
of sulphuric acid, till the whole salt is moistened. If the air be foul 
and peculiarly offensive, apply a gentle heat under the vessel to 
extricate a larger quantity of vapour; but in general, the simple 
addition of the acid to the salt will be found sufficient, unless the 
apartment be very large. 

As a purifier, the chloride of lime stands pre-eminent. A table- 
spoonful or so, may be put in a saucer, and moved from place to 
place in the room, or it may be mixed with a little water, and 
sprinkled over the floor and walls. Care should be taken, that the 
atmosphere of the room be not too highly impregnated with the 
fumes from this, or either of the articles above mentioned, otherwise, 
a troublesome cough, with soreness of the throat and breast, will be 
experienced by the patient and attendants. 

On the first appearance of typhus, or any infectious disorder, in a 
jail, hospital, boarding-school, or any other .place where many per- 
sons are crowded together, one of these gaseous fumigations should 
be employed in every room, in addition to a free ventilation and the 
greatest cleanliness. 

An eminent physician of the marine barracks of Brest, states, that 
previously to visiting the hospital, he was in the habit of introducing 
into his nostrils sponge cut into proper size and shape, and moistened 
with some essential oil. He also kept in his mouth a piece of 
orange-peel ; and in this simple method he escaped several putrid 
and pestilential diseases, which in one year killed eleven physicians 
and one hundred and thirteen students. 

Where any one is apprehensive of having caught infection, which 
may be suspected by a bad taste of the mouth, and want of appetite, 
an emetic should be given towards the evening, and on the patient 
going to bed he may be allowed a little mulled cider, or wine whey, 
with a small dose of the anodyne sudorific drops. {See Dispensatory.) 

The warm bath, if such a luxury can be commanded, would here 
be found exceedingly refreshing and beneficial.* 

*To this disease the philanthropic Dr. Benjamin Rush, of Philadelphia, tell 
a victim in the year 1813; a man distinguished throughout a long and brilliant 



200 INFLAMMATORY FEVER. 



INFLAMMATORY FEVER. 

When fever is attended with an inflammatory diathesis, or when 
actual inflammation affects any part during the existence of fever, 
the patient is said to labour under one of an inflammatory kind ; 
but according to the different parts in which the inflammation is 
seated, different denominations are given to the disorder. This 
disease, however, exists when there is no topical inflammation, and 
is distinguished by more considerable heat than usual, indicating an 
increased action of the arterial system. The fever continues for 
several days with nearly the same violence, the morning remissions 
being scarcely ever observable. 

Symptoms. — A sense of lassitude and inactivity, succeeded by 
vertigo, chilliness, and pains over the whole body, but more particu- 
larly in the head and back; which symptoms are shortly followed 
by redness of the face, throbbing of the temples, great restlessness, in- 
tense heat, unquenchable thirst, oppression of breathing and nausea. 
The skin is dry and parched, the eyes inflamed, and incapable of 
bearing the light, the pulse hard and quick, beating from ninety to 
one hundred and thirty in a minute. 

The disease usually goes through its course in about fourteen days 
and terminates critically, either by a diaphoresis, diarrhoea, hemorr- 
hage from the nose, or a copious deposite of sediment in the urine — 
otherwise it changes to a typhus. 

Causes. — Sudden transitions from heat to cold, the application 
of cold to the body when warm, swallowing cold liquors when much 
heated by exercise; too free a use of spirituous liquors; violent 
passions of the mind ; exposure to the rays of the sun ; topical in- 
flammations ; the suppression of habitual evacuations, and the sudden 
repulsion of eruptions. 

Treatment. — The symptoms which attend this fever indicate 
most strongly the necessity of having an early recourse to the lancet, 
which should be freely used. In repeating the operation, we must, 
however, be governed by the effect it produces on the pulse, and by 
the appearance the blood puts on after standing some time. If the 
former continue full, strong, and tense, and the latter exhibit a buffy, 
sizy coat on its surface, the bleeding should be repeated by all means. 
The pulse in this fever is apt to become fuller and stronger after 
bleeding, which may be easily explained ; for the plethora may be 
so great as to distend the vessels beyond their proper tone. In such 

life, by his private and social virtues. He was efficiently engaged in promo- 
ting the independence of the United States in the war of the revolution; and 
contributed chiefly to the establishment of the Medical University of Pennsyl- 
vania, in which he filled successively the most important chairs. His memory 
is cherished with the greatest respect, not only by the members of the pro- 
fession of which he was the ornament, but also by the people of the United 
States. 



INFLAMMATORY FEVER. 201 

cases, the vessels cannot act fully, and the pulse is contracted : but 
when the plethora is taken off by copious bleeding, and the vessels 
are allowed to contract properly, the pulse becomes fuller, which 
shows that the remedy is proper. 

When the fever has been of several days' standing, and the head 
is much affected, either with severe pain or delirium, topical bleed- 
ing, by the application of three or four leeches to each temple is 
advisable, should the pulse not justify the use of the lancet. 

Applying linen cloths, wetted in cold vinegar and water, to the 
forehead and temples, will often afford considerable relief. 

If nausea or sickness prevail at the commencement of the disease, 
it should be relieved by a gentle emetic. But when the determina- 
tion to the head is violent, and the vessels have not been sufficiently 
depleted by blood-letting, the aperient and diaphoretic pills, or a 
dose of calomel, or infusion of salts, senna and manna, will be most 
proper. Cathartic medicine will not only relieve the head; but pre- 
vent determinations to the lungs and liver ; and medicines of this 
class should be repeated every day or two during the continuance of 
much febrile action. 

Diaphoretics are remedies also of great utility in continued fever. 
Therefore, with a view to determine the circulation to the surface of 
the body, give the febrifuge powders or mixture, the saline mixture, 
spirit of Mindererus, diaphoretic drops, Dover's, or antimonial pow- 
ders in their usual doses. (See Dispensatory.) The warm bath 
will be found of considerable efficacy in encouraging the diaphoretic 
powers of these medicines. In many cases it will be sufficient to 
induce perspiration for the patient to bathe his feet in warm water, 
to lie in bed and drink plentifully of diluent liquors, as balm, ground 
ivy, or flax-seed tea, with the addition of a little nitre; but should 
these simple means not prove efficacious, it will then be necessary to 
resort to more powerful agents. 

It ought to be remembered, in the whole of the inflammatory 
cases, we should never have recourse to diaphoretics, till arterial ac- 
tion and general excitement are considerably reduced by blood- 
letting, and aperient medicines. And, it should also be laid down 
as a general rule, in every species of inflammatory fever, to solicit 
perspiration rather by simple means, than to force it by any violent 
measures. . When the means employed have a tendency to allay 
heat, soften the skin, relieve delirium, and induce sleep, Ave may be 
assured of their propriety. But sweating, when excited in fevers by 
stimulant, heating and inflammatory medicines, is almost sure to 
prove hurtful. It likewise proves injurious when excited by much 
external heat, or a load of bed-clothes : as also where, instead of re- 
lieving, it rather increases the frequency and hardness of the pulse, 
the anxiety and difficulty of breathing, the headache and delirium. 
When sweating is partial, and confined to the superior parts of the 
body, it will be more likely to prove hurtful than salutary. 
26 



202 INFLAMMATORY FEVER. 

The torpid state of the vessels of the surface, renders it, sometimes 
necessary to have recourse to artificial heat, in order to equalize the 
circulation and produce perspiration. Therefore, when neither the 
warm or vapour bath can be procured, hot bricks, after being dipped 
in water, or vinegar poured upon them, and surrounded with flan- 
nels, should be applied to the feet, between the thighs, the sides, or 
armpits, while the patient is moderately covered, so as to confine 
the steam or vapours. These means will very generally and 
speedily cause a relaxation of the surface, and produce an abundant 
perspiration. 

In having recourse to the warm bath, it is worthy of remark, that 
the natural temperature of the human species is about ninety eight 
degrees, but owing to the cooling process constantly taking place on 
the surface, it is here considerably lower, and hence we feel the sen- 
sation of warmth, at several points below animal heat. It is this 
circumstance which renders it difficult to adjust a precise standard, 
though, perhaps, we may not err by fixing it from ninety to ninety- 
six degrees. However, it will be proper, from the different suscep- 
tibilities of persons, always to consult the feelings of the individual, 
and so to regulate the bath that it may impart a slight, but an agree- 
able sensation of warmth. But, though the application of heat to 
the surface, in the mode which we have described, will very gener- 
ally excite sweating, it does not do so uniformly. There are cases 
attended by great heat of the surface, particularly in the early stage 
of the nervous and scarlet fever, which is aggravated by all the 
means we have enumerated, as designed to create perspiration. 
And in diseases of this nature, the effusion of cold water will be 
found more effectual in removing the constitution of the cutaneous 
vessels, than warm applications. 

In the progress of this fever, it sometimes happens that particular 
parts of the body are much affected, and that there prevails either 
great oppression of breathing, or that violent pains in the head, stu- 
por or delirium ensue. In all such cases, the application of a blister 
near the part affected, will be proper, and relief will often be quickly 
procured by it. Where there is an unusual coldness of the extremi- 
ties, with a sinking pulse, blisters to the inside of the legs will, like- 
wise, prove highly serviceable. Their efficacy, in such cases, may 
be increased by the application of stimulating cataplasms, to the 
soles of the feet and palms of the hands. Blisters very powerfully 
restore the balance of the circulation, and diminish morbid conges- 
tions. In all cases of fever there is a fulness of the vessels; and we 
find the vessels of the eyes red, the face flushed, and the eye-ball 
itself apparently enlarged ; but congestion produces, also, irritation, 
and often a less degree of phrensy. The usual wanderings of the 
mind are more rapid, the voice quick, the temper irritable, unrea- 
sonable, and occasionally violent. In each state, blisters are indi- 
cated, and often produce the happiest effects; sleep frequently 
coming on as soon as the plaster begins to stimulate. The milder 



INFLAMMATORY FEVER. 203 

symptoms of congestion yield frequently to purgatives ; and when 
these have been freely used, blisters are not often necessary. 

In this fever, as in most others, sleep is much interrupted ; and 
from a want of this, delirium often arises. Opium, here, would be 
an uncertain medicine ; for should it fail to procure rest, the delirium 
would be greatly increased by it. In such cases, a pillow of hops 
laid under the patient's head, or a strong tea of this herb, will gen- 
erally have the desired effect of procuring refreshing sleep. The 
camphorated powders or julep, are of considerable utility in fevers, 
and, in many instances, have procured sleep. The calmness which 
camphor often seems to inspire; the serenity, and even the tempo- 
rary ease, which are among its first effects, render it peculiarly 
valuable. 

Hemorrhages sometimes occur in this fever, and at times are diffi- 
cult to be restrained. If the pulse be full and hard; if much 
headache have preceded, the bleeding must be continued. But if 
it happen at the conclusion of fever, or be attended with faintness, 
antiseptics constitute the proper remedies. (See Bilious and 
Nervous Fevers.) 

Palpitation of the heart, is frequently a troublesome symptom in 
fevers. It is often produced by a redundancy of blood, as indicated 
by a florid countenance, in which case the lancet must be resorted 
to. It sometimes proceeds from the state of the stomach and bowels, 
and may then be relieved by evacuants; but it arises also, in many 
cases, from a diminution, or an irregular distribution of the nervous 
power ; and shows that the degree of debility is considerable when 
stimulants will be required. 

In some instances, the fever is continued and kept up solely by 
debility. In such cases, the bark may be employed, provided on 
using this medicine, the patient sleep well, breathe easily, and do 
not find any increased heat ; but if, on the contrary, it produce dif- 
ficulty of breathing, and restlessness, its use should be omitted. If 
by a prudent and judicious use of the remedies pointed out, we can 
lessen the congestion in the head, preserve the strength by the due 
regulation of temperature, and support it after the first days by more 
nourishing diet, we shall find little occasion for administering bark 
or other tonics. Cordials are, however, often necessary ; and of 
these, wine is the most efficacious. 

In this fever, partial evacuations, such as purging and sweating, 
which have no tendency to prove critical, often arise. When these 
happen, we must put a stop to them by resorting to the means re- 
commended in such case, under the head of Bilious and Nervous 
Fever. Critical evacuations may be distinguished from those which 
are not so, by attending to the appearance which take place in other 
parts of the system. For instance, if a purging should aviso, and 
the tongue continue foul, and the sldn dry, without any abatement 
of heat and thirst, then we may regard it as by no moans critical ; 
but if, on its taking place, the tongue become clean and moist, the 



204 INFLAMMATORY FEVER. 

pulse moderate, the febrile symptoms abate, and a gentle sweat be 
universally diffused over the skin, then a crisis may be expected. 

When this fever does not yield to the remedies pointed out, but 
assumes the symptoms of typhus, it is then to be treated as advised 
under the head of Nervous Fever. 

Among the sequels of fever are cough, night sweats, an irritable 
and irregular state of mind, a capricious, and often an inordinate ap- 
petite. These are, in general, marks of debility only, and disappear 
with returning strength. Tonics are usually employed for a time 
with little effect. The constitutional powers are at last exerted, and 
the patient gains in hours the strength which, with most powerful 
tonics, he did not attain in days. The powers of digestion, how- 
ever, do not return in the same proportion as the appetite, and re- 
lapses are not uncommon from unlimited indulgence. 

Regimen. — Throughout the whole course of the disease the pa- 
tient is to abstain from solid food and animal broths. The diet 
should be chiefly gruel, barley, or rice — water, arrow root, sub-acid 
fruits, water acidulated with lemon, the jelly of currants, or similar 
sharp fruits. It may be drunk warm or cold, as is most agreeable 
to the patient. His chamber is by no means to be kept warm, either 
by fires or by being closely shut up, as is too generally the case : on 
the contrary, it should be of a proper temperature, by allowing the 
admission of cool air into it from time to time. His bed ought to 
be lightly covered with clothes. The patient may sit up a little each 
day, according to his strength, for this will lessen the fever, headache, 
and delirium ; but when a salutary perspiration comes on, he should 
be indulged in bed. 

On his recovery, a strict attention should be paid to diet, scrupu- 
lously avoiding to over-load the stomach, and partaking of such 
things as are light, nutritive, and easy of digestion : all other causes 
likely to induce a relapse, are also to be carefully shunned. 

Fresh air, gentle exercise on horseback or in a carriage, agreeable 
company, and a moderate use of wine, will greatly contribute to the 
recovery of convalescents. Should the appetite not readily return, 
or the digestion prove weak, the tincture of bark, stomachic bitters, 
or nitric acid will be proper. 

Having pointed out, in an intelligible manner, the most approved 
method of treating the intermittent, remittent, and continued fever, 
as well as the means of prevention, it seems advisable to give some 
useful hints with regard to the prognosis^ by which the attentive 
reader may be instructed in the art of foretelling what may happen 
to the patient, with respect to the termination or change of a disease 
either by death or recovery. 

Prognosis of Fevers. — In treating the prognostics of fevers 
generally, we shall first present some useful admonitions which are 
given in the symptoms of impending disease. 

The prognostic of an impending disease may be drawn from the 
aspect of the countenance, the mode of living, the changes in habits 



INFLAMMATORY FEVER. 205 

or situations, and the critical period of life. If a person from a 
healthy state, become sallow, weak, with the loss of appetite and 
spirits, or with disturbed sleep, we may reasonably suppose that some 
disease threatens. Should these indexes be gradually disclosed, 
with a countenance tinged lightly with yellow, obstructions in the 
liver have probably taken place ; if more rapidly, with slight shiver- 
ings occasionally, a fever impends. A regular evening exacerbation, 
with cough, portends a hectic ; a more violent shiver, with conside- 
rable heat, a continued fever, a deep redness in the face, with in- 
flammation in the eyes, plainly point out accumulations in the head, 
and chiefly venous ones; but as these often arise from diseases 
impeding a free circulation through the lungs ; so that the state of 
these organs must be considered in forming the prognosis. They 
often exist together, and aggravate each other. Violent, fixed pains 
in the head, recurring at irregular intervals, and usually excited by 
every cause of increased circulation, generally show that some fixed 
obstruction prevents the free course of the blood through the organ ; 
and this is followed by convulsions, sometimes by insanity, and fre- 
quently a sudden termination of life. A fulness in the stomach and 
abdomen are certain signs of accumulation, and it depends on the 
comparison of the other symptoms, whether it be obstructions of the 
viscera, accumulated contents, or merely flatulency : the prognostic 
must be regulated by comparing the symptoms of each disease. 

The mode of life will often lead us to form some prognostic of an 
impending disorder. Late hours cannot be borne with impunity, 
except by very few; and their principal effect is to induce obstruc- 
tions in the abdominal viscera. If connected with drinking spirituous 
liquors, the effect is usually felt in the liver. The sedentary student 
has reason to apprehend biliary accumulations, with costiveness, and 
a train of hypochondriac symptoms. Excess in eating or drinking 
will equally lead us to foretell diseases of the stomach, often of the 
head, connected with the stomach; but retributive justice is fre- 
quently seen to punish the former error with the greatest severity, in 
the feelings of the patient, by loss of appetite. Almost every situation 
is apparently consistent with health, if free air be admitted ; but its 
deficiency leads to a variety of diseases from debility, which may be 
easily foreseen, and can only be avoided by a change. 

Changes of habits and situations are frequently the source of dif- 
ferent diseases, which we can often prognosticate, and sometimes 
guard against. 

Abstemiousness, suddenly adopted after free living, and the con- 
trary, are sources of disease, the former chiefly of complaints arising 
from insufficient stimulus, the latter from too great excitement. A 
sedentary, after an active life, is often attended with languor, low- 
spirits, and visceral accumulations; the contrary, at first with languor 
and fatigue, soon followed by increased tone and vigour. 

The critical periods of life merit attention also in our prognostics 
of various diseases. If scrofulous affections do not yield in the early 



206 INFLAMMATORY FEVER. 

period of life, there is little prospect of cure. The same may be 
said of epileptic fits and of Saint Vitus's dance, though to the latter 
there are many exceptions. The critical period of the female life is 
that of the cessation rather than appearance of the catamenia ; for 
unless hectic symptoms come on, the discharge, though at a much 
later period than usual, becomes regular. The period of cessation, 
if not preceded by free, often copious discharges of the menses, 
prognosticates a less healthy old age. 

Prognostics in diseases are usually drawn from the vital, animal, 
or natural actions. The vital actions, which give the best informa- 
tion, are the states of the circulation and the respiration. The first 
is chiefly known by the pulse. But before we proceed farther on 
this subject, it may be proper to describe its action. The pulse 
consists in the reciprocal contraction and dilatation of the heart and 
arteries, by the former of which the blood is propelled through every 
part of the body. Much attention is required in feeling the pulse, 
since it often misleads, unless the practitioner be accustomed to its 
examination. In estimating its strength or weakness, it is necessary 
to consider the sex, temperature, and age of the patient. The pulse 
in women is quicker than in men ; in the sanguine than in the me- 
lancholic temperament; in youth than in age. During the first year 
of an infant, its pulse is from one hundred and eight to one hundred 
and twenty ; during the second, from ninety to one hundred and 
eight ; the third, from ninety to one hundred. It varies little till the 
seventh year, when it is about seventy- five ; and in the following 
year scarcely exceeds seventy. These numbers are subject to great 
variety. The pulse is quickened after a full meal, or taking any 
stimulus; after exercise or any agitation ; it is also quicker when 
standing than sitting, and in the latter posture than when lying 
down. In hysterical patients it is excited to an inconceivable rapidity 
by the slightest circumstances without portending danger. A fat 
person has naturally a weak pulse ; but it beats, also, to a disadvan- 
tage beneath a layer of fat. This circumstance should also be at- 
tended to in our estimate. The size of the artery we can often 
estimate, for we can feel in thin persons, two-thirds of its circum- 
ference, and errors can scarcely arise from this source. A natural 
pulse is from sixty to eighty, more strictly from sixty-five to seventy- 
five. On feeling the pulse, the arteiy should be first felt gently, and 
if any doubt arise whether the pulse is weak, it should be compressed 
strongly by three fingers, and the two uppermost slowly raised. If 
the pulse be strong, and seemingly weak only from compression, the 
blood, rapidly returning, will strike fully the finger below. If really 
weak, it gradually recovers its former force. 

A strong, firm pulse is consistent with high health ; but if it strike 
the finger like a tense cord, it shows a tendency to disease, and if 
with this hardness, it be increased in frequency, inflammatory fever 
is present. A throbbing pulse, which strikes the finger with apparent 
but not real firmness, will sometimes be mistaken for what is styled 



INFLAMMATORY FEVER. 207 

the hard pulse. But this has not the same firm resistance which we 
have described. It strikes sharply, but not strongly, and the relaxa- 
tion is as rapid as the pulse is transitory. When there is internal 
irritation, the throbbing pulse will continue often to the last, showing, 
in every succeeding moment, its peculiar character more strongly ; 
but in the commencement of fevers it often so nearly resembles the 
strong pulse as to deceive. A small pulse will also be mistaken for 
a weak one, unless by a practitioner of experience; but the lightness 
of its strokes depends on the small size, sometimes the depth of the 
artery. If a pulse be at fifty-five or fifty, there is reason to apprehend 
some compression on the brain. A constant pulse of ninety in a 
minute, rising occasionally to one hundred and eight, shows a con- 
siderable irritation in the system, and is not without danger. 

If, in the early stages of fever, it rise to one hundred and twenty 
in a female, not peculiarly irritable, it portends considerable danger, 
either from debility or irritation. If at any stage it exceed one hun- 
dred and twenty or considerably exceed it, except for a short time, 
we have the greatest foundation for apprehension. 

An intermitting pulse is a mark of considerable debility, and 
prognosticates a dangerous disease. It is also a symptom of organic 
affections. This alarming view of the subject requires, however, 
some alleviation. An intermitting pulse is frequently owing to 
fulness of the stomach and bowels, and often arises from agitation 
of mind. It is also habitual ; a circumstance not uncommon. 

In such constitutions, the usual intermission, on the access of fever, 
often disappears, and the first symptom of amendment is the return 
of the intermission, which, at the end of the long fever, may appear 
alarming, if not connected with other favourable symptoms. In 
general, the favourable signs are, pulses more soft, somewhat fuller, 
and in a slight degree more slow. The unfavourable signs are, 
more thready pulses, as if the artery were smaller, pulsations quick, 
weak, and irregular. 

The state of the circulation is also known by the complexion. A 
sallowness, and a want of transparency show that the blood is not 
carried to the extreme vessels; and even when the cheeks are flushed, 
if the skin round the lips and nose be of an opaque, sallow whiteness, 
the conclusion will be the same, and the strength of the constitution 
is considerably impaired. The appearance of the eyes is equally 
indicative of strength and weakness, and the character of the features 
is preserved in proportion to the remaining strength. Each appear- 
ance depends on the state of the circulation. 

Respiration is a vital action connected with the state of the circu- 
lation, and of the greatest importance as a prognostic. Respiration 
slow, full, and deep, shows the strength and all the vital organs to 
be unimpaired, and in every situation is highly favourable. The 
weak, slight and insufficient respirations, is, in general, a mark of 
weakness; the suffocating of obstruction, the quick of considerable 
irritation, exciting rapid expiration. The stertorous shows insensi- 



208 INFLAMMATORY FEVER. 

bility, from compression on the brain ; the stridulous, inflammation 
of the trachea; the rattling, accumulations of phlegm often uncon- 
querable ; and the intermittent, attends the last efforts of expiring life. 

The animal actions, from which we may draw prognostics, are, 
the senses, muscular action, and sleep. Violent delirium is a symp- 
tom of active inflammation in the brain, and is dangerous only so 
far as it shows a violent acute disorder. The wandering delirium, 
in fevers of a low kind, is a symptom of no great danger, unless it 
come on early, and in a degree disproportioned to the state of the 
fever. In other complaints it will excite serious apprehensions, and 
shows that the inequality of excitement depends on debility. If it 
persist after the cessation of the fever, unless evidently in consequence 
of debility, there is reason to suspect an organic injury in the brain, 
and more so, if violent delirium have occurred in the early part of 
the complaint. Delirium, arising from want of sleep, is said not to 
be dangerous ; but the want of sleep itself is generally owing to a 
languid inflammation of the brain. General restlessness is a symp- 
tom of the same kind. 

Of the external senses, and their organs, the eye affords the most 
particular symptoms by which the event may be foretold. The 
sensation of black spots, which induces the patient to pick the 
clothes, as if he could remove them, is a symptom of debility, and 
is attributed to a partial palsy in the retina. It is certainly a highly 
dangerous symptom, though by no means a desperate one, as it has 
been represented. A more dangerous symptom is double vision. It 
is, in general, an early symptom of hydrocephalus. When the eye- 
lids fall, and can scarcely be elevated by the exertion of the will, it 
shows considerable weakness, and when the patient sleeps without 
closing them, great insensibility. The latter sjrmptom is, however, 
often owing to an irregular contraction of the muscles of the eyes ; 
for in such cases the pupil is drawn up under the lid. The symptom 
is not, however, on this account, the less alarming. The clear natural 
appearance of the eye is a favourable symptom ; but too great bril- 
liancy, or too quick motions of this organ, show approaching delirium. 
A severe fixed look, without an object, is a similar symptom. The 
appearance of the eyelids sometimes points out a weak state of the 
system, particularly when there is a blackness in the lower lid, to- 
wards the inner corner of the eye. 

A noise in the ears, in fevers, is said to be a sign of approaching 
delirium, though frequently a symptom of weakness only, and often 
occurs from this cause, in weak and old people. If this noise occur 
in the beginning of fevers, it is said to foretell a violent and a tedious 
disease. Hearing particularly acute is often a precursor of delirium ; 
and without fever, it is the effect of strong excitement in the brain. 
Deafness in fevers is said to be a favourable symptom; we can, at 
least, observe that we have not found it unfavourable. Vitiated taste 
is very common, and offers no particular prognostic. 

Lassitude on the attack of fevers, in so great a degree as to pro- 



INFLAMMATORY FEVER. 209 

duce fainting, is always a very dangerous occurrence. If attended 
with a considerable wandering, the danger is greater. 

It is a favourable sign if, in the beginning of a fever, the patient 
can sit erect with his head elevated. And, if the patient can sup- 
port himself in bed, and occasionally turn on his side, about the 
tenth or twelfth day, the circumstances are favourable. 

Sleep, if calm and refreshing, is always a favourable symptom ; 
but if interrupted, broken by terror, excited by dreadful images in 
dreams ; if, instead of tranquil rest, the patient starts, catches, talks 
in a hurried manner, though not conscious of terror, it is unfavoura- 
ble. Deep sleep is itself a disease, and shows a considerable op- 
pression on the brain ; yet, at the period of a crisis, if attended with 
a soft pulse, moderately slow, and a soft, moist skin, it is salutary. 
After a crisis, the deepest long continued sleep is not dangerous, if 
not attended with stertor, (a sound like snoring,) or with a pulse pre- 
ternaturally slow. 

The natural actions which furnish prognostics, are, digestion and 
its consequences, and the various excretions. In fever the appetite 
is at once destroyed ; nor is it a favourable sign, in an acute disease, 
that it should remain or return too soon. 

The appearance of the tongue is of considerable importance as a 
prognostic. Whiteness of its surface is a sign of fever ; and if white 
and dry, it shows the fever to be more considerable. In the progress 
of a fever it becomes brown, a darker brown, and even black ; and 
these colours are usually seen when the tongue is dry and hard. 
While the edges continue clean, and of their natural, speckled ap- 
pearance, there is little danger ; and, indeed, fevers have terminated 
favourably, though the tongue has been for many days, dark, dry, 
and even black. The tongue, sometimes, in the course of fever, 
becomes suddenly clean, and of a shining red. This, in general, 
shows that the fever will be of long continuance. The tongue 
sometimes cleans slowly in elderly and debilitated constitutions. 
And, independently of fever, in such habits, the tongue is often 
black at the back part. 

A heavy load in the stomach is an unfavourable symptom, unless 
it arise from indigestible food ; since it shows either an accumulation 
of viscid mucus, or a want of energy in the organ. When the irri- 
tability of the stomach is exhausted by excessive stimuli, the effect 
is a heavy load. 

Vomiting is the connecting symptom between the affections of 
the digestive organs, and those of the secretory ones. When violent 
and incessant, without previous accumulation of bile, it is an unfa- 
vourable symptom, as it generally arises from irritation of the brain : 
even when, from bile, it is distressing, for the act of vomiting emulgea 
the biliary duct, and the inverted motion of the duodenum carries 
the bilious fluid back into the stomach, thus furnishing new fuel for 
the flame. 

A frequent diarrhoza, independently of mucous inflammation, is 
27 



210 INFLAMMATORY FEVER. 

dangerous, as it shows considerable debility, and a difficulty of re- 
taining the food long as is necessary for its assimilation. 

The other excretions, which have attracted attention as prognos- 
tics, are the perspiration ; the urinary and alvine evacuations. It 
is generally acknowledged, that the salutary perspiration is not at- 
tended with heat, is not clammy to the touch, is generally diffused 
without any load, uneasiness, or anxiety. The sweat of an opposite 
kind does not relieve, but debilitate. Cold clammy sweats arise 
from a total relaxation of the exhalents, and are, in general, the pre- 
ludes of death. 

The state of the urine has also afforded numerous prognostics, and 
the discrimination of its clouds, its sediment, &c, has been peculi- 
arly minute. The greater number of these appearances may be dis- 
regarded. Urine must be examined only after it has been made for 
some time. It should be poured into a glass while yet warm, and 
kept in air moderately cold. With such precaution, some useful 
lessons may, perhaps, be drawn from its appearance. 

The quantity of urine varies in different persons, and, in the same, 
at different periods. Hence, from this no conclusion can be drawn. 
In general, where it is remarkably deficient, it is at other times 
equally redundant; and this chiefly occurs in hysterical constitu- 
tions. The excess is also at no time dangerous, unless the quality 
of the urine is changed, since it only depends on irregular action of 
the renal vessels. When the urine is in small quantity, its colour 
is necessarily high ; and at the conclusion of a gouty paroxysm, as 
well as of a paroxysm of an intermittent, it throws down a brick- 
coloured sediment. When highly red, without depositing any sedi- 
ment, it shows a violent, and probably a long fever. In general, a 
scum on the top, in the early period of fevers, seems to show consid- 
erable debility ; and we have usually found such fevers slow and 
tedious. A cloud, suspended at first near the top, and afterwards 
falling lower till in succession it reaches the bottom of the glass, are' 
favourable signs ; and a suspended cloud, previously to the fourteenth 
day, shows that the disease will terminate at that period. If it ap- 
pear after the fourteenth day, the disease terminates at the twenty- 
first, gradually lessening on the intervening days. 

The progress of the cloud in the urine, in case of fever, is regular. 
It is, at first, suspended at the top, gradually falls, though for a day 
or two, often stationary near the middle of the glass, and at last 
reaches the bottom. It falls to the bottom often some days before 
it is accompanied by any sediment ; but when a white or reddish 
sediment also falls down, the crisis is nearly complete. The urine 
is sometimes turbid, if not at the moment of discharging it, very soon 
afterwards ; and this, according to the authors of prognostics, is said 
to show an insidious disease. Frothy urine, or which long retains 
the air bubbles, is said to show a tedious disease, or a slow consuming 
fever. In bilious fevers, the urine is sometimes of a green or black 
colour, which shows a highly putrid state. The black is more dan- 



INFLAMMATORY FEVER. 211 

gerous, but unless highly fetid, we have frequently seen it without 
its being followed by a fatal event. In chronic diseases, red urine, 
depositing a copious, red, scaly, or branny sediment, is a mark of 
considerable debility. A mucous and viscid sediment is usually 
alarming from the apprehensions which it excites of abscess in the 
bladder. Mucus is, however, light and equable, wholly free from 
foetor, and arises from an inflammation of the mucous membrane. 
It arises also from any irritation of the neck of the bladder ; and is a 
frequent symptom of gravel and calculus. 

The nature of the alvine discharge is of considerable importance, 
and these should be frequently examined with attention. In acute 
diseases the discharge is often estimated by the number of motions 
rather than their appearance, and we have been told there has been 
a free discharge from the bowels, when the stools had not the slight- 
est feculence. Liquid, frothy, watery motions, with little colour or 
smell, denote, in general, a tedious fever, for in every fever there 
seems to be an obstinate retention of the faeces, and motions of this 
kind show that the spasm is peculiarly violent. When the stools, in 
the beginning, are highly fetid and bilious, it has been accounted a 
dangerous symptom ; but if the discharge be free and copious, they 
are rather favourable. Calomel will, through the whole course of a 
fever, often bring off such motions by its superior power on the biliary 
secretion. Small, black, pitch-like motions, are always dangerous, 
and show equal weakness in the alimentary canal and the biliary 
system. On the contrary, hardened excrement, brought off with 
little straining or colic, is favourable. 

From the remarks which have been offered, it will appear that 
our prognostics of fever must be taken generally from the signs and 
degree of debility. This is obvious often to the sight. Every cir- 
cumstance which regards a patient in a fever, will, by attentive 
observation at the bed-side, throw some light on this subject. 

The situation of the patient is dangerous, if the character of the 
countenance is soon lost; if the eyes apparently glare on vacancy; 
if the answers are rambling and incoherent ; if slight, partial involun- 
tary contractions occur in the features; if the tongue trembles, or is 
soon dry and dark; if he soon declines turning on his sides, lies on 
his back, and sinks down on his bed ; if the extremities are cold and 
benumbed; if the tendons are particularly tense, and occasionally 
start ; and if he appears to pick off or remove any dark spots on the 
bed clothes, or wishes some supposed dark object to be removed : 
each of these symptoms is a mark of debility ; and the earlier they 
occur in fever, the greater is the danger. 

If, however, in a fever, the expression of the countenance is un- 
changed; if the mind is steady and unruffled; the sleep, though 
short and interrupted, refreshing, and the patient is sensible of having 
slept; if the tongue is clean at the edges; the abdomen neither tense 
nor painful ; if the patient lies on either side, and awakes without 
hurry or confusion, we may prognosticate a, safe termination. 



212 BRONCHITIS — COLD. 

In the more usual cases of fevers, if the disease has been properly 
managed in its earlier period, and the circumstances are on the whole 
favourable, there are few instances in which a salutary change does 
not take place on the tenth or fourteenth day. Where this is not 
observable, a gradual amendment takes place, which is clearly con- 
spicuous on the seventeenth, and the fever has disappeared before 
the twentieth. 



BRONCHITIS. 



Often the voice and the cough sound like those of croup, and 
with this disease it is sometimes confounded. 

Treatment. — In this complaint blood-letting and leeching have 
been recommended, but in the first stage, no remedy is more useful 
than puking. Counter-irritation by antimonial ointment, and blisters 
will prove serviceable. Great attention should be paid to the tem- 
perature of the extremities. A warm bath has been of signal use in 
promoting the comfort of the patient. Sometimes the patient is so 
weak and languid as to be unable to cough. In this case, a stimu- 
lant often repeated, will be found of great advantage. 



COLD, 

Or, in the language of the nosologists, Catarrh, is a disease of 
the inflammatory kind, which occurs more frequently on sudden 
changes of the weather, and attacks persons of all constitutions, but 
especially those of consumptive habits. 

It is also at times epidemic, when it is known by the name of 
influenza, and has been erroneously considered as depending upon a 
specific contagion for its cause. 

The influenza generally pays us a visit every six or seven years. 
The season of its visitation is the middle or latter end of autumn, 
after a long spell of dry weather. It would appear to be no respecter 
of persons, knocking equally at the door of the rich and the poor, 
and attacking the young no less than the aged. 

Symptoms. — Its first symptoms are a stoppage of the nose, dull 
pain, with a sense of weight in the forehead; stiffness in the motion 
of the eyes, and soon after cough, hoarseness, an increased secretion 
of mucus from the nose, and tears from the eyes, attended with more 
or less fever, and sometimes sore throat. 



COLD. 213 

When this affection prevails extensively among a people, it is 
denominated influenza. The difference between catarrh and bron- 
chitis, is only in the location — the former is seated in the mucous 
membrane or lining of the nose, cells of the forehead, and upper part 
of the wind-pipe — the latter or bronchitis, is situated lower down in 
the tubes passing to the lungs. 

Cause. — This disease is generally the effect of cold, which, by 
obstructing the perspiration, throws the redundant humours upon 
the nose, fauces, and lungs ; or to those great physical changes which 
give rise to epidemics. 

Treatment. — The treatment of this disease, as of all others of an 
inflammatory nature, consists of the antiphlogistic, or cooling reme- 
dies. Where it is slight, little else will be necessary than to pay 
attention to the state of the bowels ; live abstemiously, avoid cold, 
and whatever may increase the feverish habit. 

Bathing the feet in lukewarm water, or bran and water, a little 
hotter than milk just taken from the cow, at the same time that 
something warm, as a glass of hot toddy, punch, or mulled wine, is 
taken internally, forms a remedy upon which many people place 
their sole reliance for the removal of their colds. But this, unques- 
tionably, is a hazardous practice ; for it may be regarded as a general 
rule, in inflammatory diseases of whatever description, that all at- 
tempts to excite perspiration, by stimulating and heating drinks, will 
be uniformly injurious. 

Foot-bathing is certainly a simple, and often found to be a power- 
ful assistant of the operation of other remedies, by equalizing the 
circulation and promoting perspiration. In this practice, however, 
much caution is necessary not to get fresh cold; the feet should be 
carefully and speedily wiped dry, and afterwards wrapped up in 
a warm dry flannel, or the patient should immediately go into a 
warm bed. 

When there exists any febrile action, the free use of cold water, in 
the early stage of the disease, forms a safer and a much more effica- 
cious remedy than the administration of warm or stimulating liquids. 
A glass or two of cold water, taken upon going to bed, is a very 
common, and sometimes a successful remedy for cold. 

The impression of cold drink upon the stomach, independently of 
its general refrigerant operation, seems to have the effect of promo- 
ting the action of all the secretory and excretory vessels. Taking a 
draught of cold water every hour or two, with ten or fifteen grains 
of nitre dissolved in it, will be found a remedy as effectual as it is 
simple in almost every case of inflammatory catarrh. Should it be 
observed that the nitre has a tendency to increase the cough, nausea- 
ting doses of tartar emetic should be added to each draught of cold 
water ; which promote expectoration as well as diaphoresis, without, 
at the same time, increasing arterial action. When recourse is had 
to this medicine, dissolve three grains of tartar emetic in a quart of 
pure cold water, of which solution a gill to a half pint may be given 



214 COLD. 

to an adult every three or four hours, or at such intervals as will 
produce a very gentle nausea, without creating any considerable de- 
gree of uncomfortable sensation. The consent of the stomach with 
every part of the animal system is so generally acknowledged, that 
this organ is now admitted to be the medium through which almost y 
all medicines, taken internally, produce their effects upon every part 
of the frame. Hence, cold applied to this viscus must be attended 
with more speedy and certain effects than to any other part whatever. 
Its operation in this case is simple : it produces its effects merely by 
the abstraction of the stimulus of heat. 

Although it will be admitted these two plans of cure, however 
contradictory, have both occasionally succeeded ; yet the cool mode 
of treatment, when employed with a due degree of circumspection, 
is unquestionably the most advisable, for the successful removal of 
the disease in its incipient state. Of all the improvements which 
have been made for many years, in the practice of medicine, the 
introduction of the use of external cold, in the treatment of acute 
disease may be regarded as one of the greatest importance. The 
theory upon which it is founded is rational, and the practice to which 
it has led, has been attended with the most happy effects. In fevers, 
inflammations, and eruptive disorders, it has restored thousands who 
would otherwise have perished ; but its free and extensive use in 
catarrh, is inadmissible, as, by exposing the body afresh to a low 
temperature, the original mischief would be often spread wider, or 
the foundation would be laid for other diseases more formidable. 
However, upon the accession of the symptoms indicating the com- 
mencement of the disease, the air which immediately surrounds the 
body, and which is inhaled in respiration, should be as cold as is 
consistent with comfortable feeling. Perhaps a temperature from 
forty to fifty degrees, will be most salutary. An approximation to 
this may always be effected by the patient remaining, in cold weather, 
in a room warmed only by a small fire ; and, in the milder months, 
by a free exposure to the open air ; in all cases carefully avoiding 
causes which operate in rendering the cold air injurious. The 
covering of the body, both day and night, should be as light as the 
external temperature will allow, and every thing taken in the stomach 
should be perfectly cold. By pursuing the refrigerating plan, the 
activity of the whole arterial system is diminished, the inflamed ves- 
sels are relieved from that redundancy of blood, and increased action, 
in which the disease consists, and finally recover their wonted 
healthy tone without any morbid relaxation of their extremities. 
Whereas, the mode of treatment which admits of warm drinks, warm 
rooms, and warm air, when it operates in a manner the least dan- 
gerous, produces, by excessive excitement, such a relaxation of the 
exhalents of the bronchia, as to admit of a secretion of mucus, or 
pus, which, though it relieve the topical inflammation, by what is 
called expectoration, either lays the foundation for chronic catarrh, 
or terminates in consumption. 



COLD. 215 

Full vomiting, at the commencement of the complaint, will seldom 
fail to prevent its farther progress. The operation of an emetic, be- 
sides its more immediate effect in evacuating the contents of the 
stomach, produces such a universal commotion in the system, as to 
excite every minute fibre into action ; and in this wa}^ it is that emetics 
prove salutary in the majority of complaints in which they are ad- 
ministered. They excite a new and powerful action, which expels 
or overbalances the pre-existing weaker one. Thus they arrest the 
progress of fever, and thus, if administered at the accession of catarrh, 
they will prevent the occurrence of the symptoms which would 
otherwise infallibly ensue. In three cases out of four, perhaps, if 
upon feeling a stuffing of the nose, dull pain in the head, sneezing, 
and other symptoms which mark the commencement of the com- 
plaint, a person has resolution to try the experiment, he will find a 
brisk emetic have the effect of completely restoring him to his natural 
feeling. Emetics will also prove beneficial, not only at the com- 
mencement, but at other periods of the disease, particularly when 
the lungs are oppressed with phlegm. 

In the treatment of this complaint, the indications which arise to 
be fulfilled, may be reduced to the following heads : — To reduce in- 
flammatory action in the early stage — -to palliate urgent symptoms — 
and to diminish irritation in the protracted stage. 

When the disease is violent, aperient medicines, in conjunction 
with blood-letting in a larger or smaller quantity, should be resorted 
to, and repeated as the symptoms may require. 

Although the occasional use of aperients is indispensable, and 
should be had recourse to early in the complaint, yet very active 
purging is often found more prejudicial than serviceable, by dimin- 
ishing expectoration. The saline aperients, as Epsom or Glauber 
salts, in the form of the cathartic mixture, (see Dispensatory,) have 
the advantage over others in febrile diseases, being sedative and 
cooling. Those, however, who have an aversion to salts, may sub- 
stitute any other opening medicine, as castor oil, rhubarb, sulphur, 
and cream of tartar, or senna and manna. But the purgative which 
of all others is most powerfully febrifuge, is calomel, which may 
always be administered with perfect safety, provided the patient 
guard properly against imprudent exposures to wet and cold at the 
time he is under its operation, and there is no peculiarity of tem- 
perament that militates against its use. When recourse is had to 
calomel, give it in the form of the aperient and diaphoretic pills, {see 
Dispensatory^) or conjoin therewith a few grains of ipecacuanha, or 
a small portion of tartar emetic ; and in a few hours after swallowing 
the medicine, or, if it be taken at bed-time, on the next morning, 
give a small dose of Epsom salts or castor oil. 

In catarrh, the means which nature occasionally takes for its re- 
moval, or, in other words, the symptoms which mark its critical or 
spontaneous termination, are, principally, a copious and equable How 
of sweat, an increased secretion of mucus from the membrane of die 



216 COLD. 

trachea and bronchia, the production of a diarrhoea ; and hence, an 
indication for the use of diaphoretics , expectorants, and laxatives. 
Therefore, with the view of regulating and promoting the salutary 
efforts of nature, it is advisable, during the interval of purging, if the 
skin remain obstinately dry, and there exist a general feverish dispo- 
sition, to give the saline mixture in the state of effervescence, spirit 
of Mindererus, the febrifuge mixture or drops, Dover's, antimonial, 
or febrifuge powders, {see Dispensatory^) or infusion of seneca root, 
in their usual doses, with diluting liquors; as flax-seed, balm or 
ground ivy teas, weak wine whey, barley water, &c, in order to pro- 
duce a determination to the surface. 

When the cold chiefly occupies the head, it has been advised, to 
suffer the whole head to remain, for a considerable time, in contact 
with the steam of water, as hot as the patient can bear. And this 
is to be done in the following manner : — While the patient sits up 
in bed, a vessel containing two or three quarts of water, may be 
placed immediately under and before his face, letting it rest on his 
lap, and a piece of flannel or thin blanket being put over his head, 
and extending under and around the pan ; this will keep the steam 
in contact with the face, neck, and head, and, at the same time, will 
admit sufficient air for respiration. In cases of great stuffing up of 
the nose, and difficulty of breathing through the nostrils, this prac- 
tice, has frequently had the effect of removing these symptoms in 
the course of a few hours ; but it is seldom successful, where there 
are considerable pain and oppression at the fore-part of the head, in 
consequence of some inflammation occupying the cavities communi- 
cating with the nostrils. In such cases, a pinch of snuff, united with 
Cayenne pepper, has afforded some relief. But where the pain is 
extremely severe, the patient will experience most relief from a 
blister applied to the back of the neck, or to one or both temples. 

When the mucous membrane of the nose is much affected, it 
should be washed frequently with a thick mucilage of gum Arabic, 
or pith of sassafras, (see Materia Medica,) or smeared, from time to 
time, with a litile tallow, thorn-apple, or simple ointment. (See 
Dispensatory.) 

An inflammation of the throat, producing soreness and difficulty 
of swallowing, is an occasional symptom of this complaint; and 
where it is slight, it will readily be removed by taking the nitre 
lozenges, (see Dispensatory^) or small portions of nitre in the 
mouth, and swallowing them as they slowly dissolve. Where it is 
of a more severe nature, the application of onions to the feet, (see 
Materia Medica,) or the remedies advised under the head of sore 
throat must be resorted to. 

In case of a pain or oppression at the breast, after the inflamma- 
tory action of the system is pretty well subdued, the application of a 
blister as near as possible to the affected part should not be omitted. 

The most prominent symptom of cold is cough, which, being uni- 
formly present, and often very distressing, is usually that to which 



COLD. 217 

the patient directs the chief part of his attention. — The medicines to 
be resorted to for the purpose of alleviating cough, and producing 
expectoration, are mucilaginous and sheathing drinks, as flax-seed 
tea, barley-water, &c, or taking now and then, a table-spoonful of 
the flax-seed syrup, or a tea-spoonful of equal parts of sweet oil and 
honey, or a mixture composed of one part oil, and two of honey and 
syrup, or some of the more simple pectoral mixtures. (See Dispen- 
satory.) After the inflammatory symptoms have abated, the pec- 
toral mixtures combined with laudanum or paregoric, (see Dispen- 
satory,) will afford the greatest relief; and where the patients rest is 
particularly disturbed in the night, an opiate at bed-time will be 
highly necessary, but it should be combined with some diaphoretic, 
as in the form of the anodyne sudorific bolus or draught, (see Dis- 
pensatory^) or by giving two parts of paregoric with one of antimo- 
nial w 7 ine in some warm tea. 

Barley, hoarhound, and sugar candies, liquorice, and various syrups 
of indigenous simples, are universally employed for the purpose of 
allaying the tickling which produces cough. The effect of all rem- 
edies of this kind, is to smear over the glottis or fauces, and, by thus 
sheathing them, rendering them less susceptible to the irritation. As 
they have the advantage of being innocent, and are usually found 
to afford a temporary relief, they may, in every case, be resorted to 
with advantage, as palliatives. 

Whenever a cold, either in consequence of its severity, or from its 
having been neglected in the first instance, runs out to a considera- 
ble length, it is usually kept up by a state of simple irritation of the 
part, which supervenes upon the disappearance of the inflammation, 
and becomes as it were habitual, exciting the vessels to an increased 
secretion of mucus, and producing cough by sympathy with the 
larynx. In this protracted stage of the complaint, when the cough 
and spitting alone remain, it is absolutely necessary that the patient 
should carefully guard against all unnecessary exposure to cold, and 
to defend particularly the breast and feet ; and when obliged to go 
into an air of low temperature, to increase his clothing, and hold a 
thin pocket handkerchief before his mouth and nose. The vessels 
are in a state of relaxation or debility, when the cough is long pro- 
tracted, and the consequence of any unusual application of cold is 
very generally a suppression of their exertions, and a subsequent re- 
newal of the inflammatory affection. And it is in this way that 
colds are often kept up for months, until they degenerate into a per- 
manently morbid state of the lungs. In such cases, the nitric lac 
ammoniac, (see Dispensatory,) in doses of a table-spoonful in a cup 
of flax-seed tea, or sweetened water, every four hours, to adults, will 
be found a most valuable remedy. Benefit will also be derived from 
wearing a Burgundy pitch, or some warm adhesive plaster, upon the 
breast, or between the shoulders. 

Should these means prove ineffectual, one or two grains of calo- 
mel, with a double quantity of powdered squills, taken by an adult 
28 



218 COLD. 

at bed-time, and continued until a ptyalism be produced ; and after- 
wards the nitric lac ammoniac, administered as above directed, may 
be depended upon. 

Another remedy which has succeeded in this state of the disease, 
is the tincture of digitalis, in doses of ten drops, three times a 
day, to adults, and its efficacy will be increased, by using the vapour 
bath. 

Inhaling the vapour of hot water is a remedy which has long been 
in use, in all inflammatory complaints of the chest. However, upon 
the first commencement of catarrh, it has the effect of rendering the 
subsequent symptoms more severe ; but at a more advanced period 
of the complaint, it tends powerfully to arrest its progress, by in- 
creasing the secretion from the glands and vessels of the part, and 
thereby diminishing their inflammatory action. The vapour has 
been found most efficacious when impregnated with vinegar or cam- 
phor, or infusions from emollient herbs. The inhaler, invented by 
Dr. Mudge, of England, is well adapted to render the process per- 
fectly convenient for children. But a common funnel will form a 
very good succedaneum for the inhaler, when this cannot be conve- 
niently procured, the broad part being inverted over a vessel con- 
taining the water, and the steam being received by the mouth ap- 
plied to the small end. Should a funnel not be at hand, a tea or 
coffee-pot, may be substituted, and the operation continued from a 
quarter to a half hour. In this manner, the vapour bath may be re- 
ceived twice or thrice a day, carefully avoiding sudden exposure to 
the external cold air. According to Dr. Mudge, a tea-spoonful of 
paregoric, taken at bed- time, in some warm liquid, and the use of 
the warm vapour arising from simple water, through this machine, 
will be sufficient to cure a catarrhous cough in a night's time. 

An unpleasant and not unfrequent sequel of this complaint, is a 
hoarseness, or diminution of voice, depending upon a state of the 
muscles, subservient to speech, approaching to palsy. This is gen- 
erally of a temporary nature, though it has been known to continue 
for several months. In such cases the infusion of seneca-root, with 
one fourth of honey, has been employed in doses of a table -spoonful 
every two or three hours, and, at the same time, some of it used as 
a gargle, with the most happy effects. It has also been readily 
cured by taking a tea-spoonful of the syrup of horse-radish every 
hour or two ; or by retaining in the mouth a piece of this root, or by 
gargling the throat frequently with an infusion of red pepper, mus- 
tard-seed, or horse-radish. This symptom has been known to be 
instantly removed by means of electricity, and also by inspiring 
oxygen, or pure air. It is of importance, if the patient be in a de- 
bilitated state, to invigorate his constitution by nutritious diet, regular 
exercise, and removing to a more salubrious air. A popular writer 
of considerable celebrity, Dr. White, states a case in which not only 
a loss of voice, but a partial palsy of the muscles of deglutition, pro- 
ducing an imperfect, and, at times, a total incapacity of swallowing, 



COLD. 219 

ensued upon the disappearance of a severe catarrh, attended with 
sore throat ; and which did not go off for the space of a month. In 
this case, the patient was in the habit, previously to an attempt of 
deglutition, to suffer a tea-spoonful of brandy to pass over the affected 
parts; after which, she immediately became capable of swallowing 
with ease, but again lost the power of doing so, after the effect of the 
stimulus had worn off. 

Should hoarseness occur in the inflammatory or early stage of the 
disease inhaling watery vapours, bleeding, cold water, and demul 
cents constitute the proper remedies. 

Although the attendant symptoms of cold, in its incipient stage, 
seldom amount to such a degree of urgency as to demand the anti- 
phlogistic mode of treatment in its more active forms ; yet if it be 
aggravated or rendered frequent in its return, by neglect or impru- 
dence, it becomes a malady which not only combats, but often de- 
feats the skill of the most experienced physician. And it should be 
remembered whenever the cough is frequent, the fever considerable, 
and the breathing intercepted by transient pain, or tightness of the 
chest ; unless the most powerful means, as bleeding, purging and 
blistering, with diluting drinks, be early employed, inflammation of 
the lungs will succeed, which, if not speedily removed, will inevita- 
bly terminate in consumption. 

I have now presented to my readers, in a manner familiar to every 
capacity, the most approved plan of cure of this destructive com- 
plaint. Should it be adopted in the domestic management of colds, 
I shall not have wholly failed in my earnest endeavours to lessen 
some of the dreadful ills ; for, of all the diseases incident to the hu- 
man species, there is none so frequent in its occurrence — none wmich 
excites so little attention — and none, perhaps, when neglected, is so 
often followed by fatal consequences, as that under the name of cold 
or cough. It is the rock upon which the health and lives of thou- 
sands have been wrecked. 

The frequency of this disease, from the sudden changes of weather 
to which our climate is subject, and the slight degree of alarm gen- 
erally excited by what is called " only catching a cold" too often 
occasions that neglect, which gives rise to the most distressing 
maladies, such as quinsy, pleurisy, inflammation of the lungs, 
rheumatism, &c. 

Fully satisfied that numbers fall victims to the supposed insignifi- 
cance of this insidious enemy, I have thought it my duty thus to 
warn the inattentive. 

Regimen. — A rigid attention to diet, is not to be looked for at the 
occurrence of every slight attack of cold ; but when the disease rises 
to such a degree as to produce a state of general febrile indisposition, 
it will be absolutely necessary for the patient to abstain from eveiy 
thing of a stimulating nature. He should confine his diet to lighl 
things, of easy digestion, as arrow-root, sago, tapioca, rice-milk, cus- 
tards, jellies, fruits, (fee., &c. Where the symptoms are so trilling as 



220 COLD. 

not to render an abstinence, from animal food requisite, those means 
of a more digestible nature should be chosen; and if the patient 
have been accustomed to the use of spirituous liquors, he should 
substitute for them, porter, cider, or wine, diluted with water. Every 
* thing which either stimulates the glottis and fauces in deglutition, or 
proves indigestible after being received into the stomach, invariably 
increases the cough, and consequently is injurious. 

Prevention. — To guard against this disease, the utmost attention 
should be paid to a due regulation of the clothing, which ought to 
be neither too thin, nor so irregularly disposed, as to leave one part 
of the body naked, whilst the rest is burdened, and too warmly 
clad; an error frequently committed among children and young 
persons. Warm rooms and impure air may weaken the body, but 
warm clothing can never be injurious in cold weather. The use 
of flannel cannot be too highly recommended as a preventive of this 
disease ; and if an objection should be made to wearing it next to 
the skin, on account of the irritation it occasions, it may be worn 
over the linen. 

But, while thus careful to guard against the morbid influence of 
cold, by accommodating our dress to the weather, we should be 
equally cautious not to run into the opposite extreme. Too much 
clothing produces a delicacy of frame that disposes no less to disease 
than an imprudent disregard of necessary clothing. 

There are two parts of the body more especially liable to receive 
the ill impressions of cold, and communicate them to the rest — the 
feet and the chest, and, with the delicate and susceptible, if fashion 
govern in all other respects, these, at least, should be defended with 
the utmost care. 

Whenever the whole or a part of the body has been exposed to 
the long-continued action, or otherwise to the sedative influence of 
cold, it is said to be chilled, or, in other words, it falls into a state of 
atony, in consequence of the reduction of its nervous energy, and is 
thereby deprived of the faculty of duly supporting its natural heat. 

This state occurring universally, and to a great extent, usually 
proves destructive to life. When local or general in a less degree, 
it proves the exciting cause to various diseases of the active kind, 
determined in their seat by the particular predisposition of the person ; 
the weakest part of the body invariably receiving the noxious im- 
pression, however generally applied. Thus, those whose pulmonary 
system is weak and irritable, will have catarrh, or inflammation of 
the lungs ; others, whose muscular fibres are most susceptible, will 
be attacked with rheumatism ; and those addicted to drunkenness, 
will, perhaps, be afflicted with an inflammation of the liver; and so 
of various other inflammatory affections. Colds, however, are by 
far the most frequent; which, ^perhaps, may be accounted for, in a 
great measure, from the lungs being so particularly exposed to all 
the varieties of atmospherical temperature. 

A person not particularly liable to catarrh, would probably seldom 



COLD. 221 

feel ill effects from being chilled by an exposure to the cold air, if 
he were careful to restore the natural warmth of the body by degrees ; 
but if, during the presence of that uncomfortable state of feeling, 
produced by the diminished temperature, he either suddenly come 
into a warm room, or drink of warm stimulating liquids, he will 
seldom escape with impunity. 

It should be remembered that when any part of the body has been 
exposed to cold, it is liable to be much more affected by heat, than 
before the exposure. Of this, the method of treating frozen limbs in 
cold countries, affords a beautiful and decisive proof. Were a frozen 
limb to be brought before the fire, or immersed in warm water, a 
violent inflammation would come on, and speedily terminate in mor- 
tification. They, therefore, rub the parts benumbed with snow, and 
then very gradually expose them to a warm temperament. 

Hence, it will evidently appear, that strong drinks, both before 
and after exposure to severe cold, must be highly dangerous ; and 
it should always be remembered, that when the body has been 
chilled or much heated, it must be brought back to its natural state 
by degrees. 

The common prudence of shunning, when heated, a torrent of 
cold air from the crevice of a door or window, or throwing off the 
clothing immediately after taking exercise, is so obvious, as not to be 
required to be enlarged upon. Putting on wet clothes, or lying in 
damp sheets, or sitting in wetted rooms, is also so well known to be 
injurious, that it is hardly necessary to admonish people against such 
obvious improprieties. 

The operation of moisture in producing catarrh, appears to act in 
the same way as cold, by proving a sedative. The feet being most 
liable to receive the impressions of damp, as they are of cold, one of 
the most frequent causes of catarrh is getting them wet ; to guard 
against which, is of importance to those liable to the complaint; and 
when a person has been exposed to the wet weather, the clothes 
should be changed as soon as possible, after wiping the body and 
extremities with a cloth wetted in spirits, to which a little table salt 
has been added. 

The predisposing causes of catarrh are, 1st. Original peculiarity 
of constitution; secondly, an acquired morbid irritability of the 
pulmonary system ; thirdly, a morbid delicacy of frame, induced 
by enervating indulgences, or weakening occupations, or occasional 
and accidental debility. The exciting causes are those, which, when 
applied to the body, under a state of predisposition, excite disease 
into action. 

It is worthy of remark, that however predisposed to disease the 
constitution may be, by carefully guarding against the causes which 
more immediately produce it, its dreaded incursions may usually be 
prevented, and health may often be preserved to old age. The im- 
portance, therefore, of avoiding the exciting causes of a disease, so 
nsidious in its nature, cannot be too strongly insisted upon, more 



222 cold. 

particularly in the early periods of life, and in constitutions peculiarly 
obnoxious to its attacks. 

Some persons are so susceptible of cold, as to be unable to endure 
the least change of temperature, without having a violent fit of 
sneezing, coughing, and other symptoms of incipient catarrh. And 
these will recur so frequently, and are of so temporary a nature, as 
to justify the expression, that they are seldom free from cold. The 
means of obviating this susceptibility is, by gradually and cautiously 
inuring the habit to the impressions of cold, by accommodating dress 
to season and personal feeling; and, when changes from cold to heat, 
or the contrary, are unavoidable, in guarding against the transition 
being sudden and immediate.' 

Nothing so much contributes to enervate the powers of the human 
frame, as an excess of artificial heat. The ruinous effect of this in- 
dulgence is, that our health and comfort are destroyed by the frequent 
recurrence of some one or other of those disorders which have their 
origin in cold. Debilitated by the perpetual stimulus of heat, we 
become sensible to every, even the slightest, variation of atmospheri- 
cal temperature. Few, indeed, of the refinements of modern luxury 
are more prejudicial to health, by rendering the body susceptible of 
cold, than the living in rooms heated by stoves or enormous fires. 
Let those who have at heart the preservation of their health, and 
the vigour of whose frames is as yet entire, carefully avoid making 
this effeminate indulgence necessary to their comfort. Let them, 
by gradually training themselves to bear the impressions of cold, 
endeavour to induce that enviable state of hardiness, that will enable 
them to brave, with impunity, the vicissitudes of the atmosphere of 
our climate. It is in the power of every one, to render the apart- 
ments they occupy, cool and airy ; and there are none, perhaps, who 
have it not in their power, more or less, frequently, during the day, 
to breathe the open air without doors. In endeavouring, however, 
to habituate the system to two degrees of temperature, one caution 
is of the most essential importance to be attended to ; namely : never 
to remain inactive, either in the open air or in cool apartments, long 
enough to induce a continued and unpleasant sensation of actual 
cold. This, in all cases, would effectually counteract the design 
proposed ; and by frequent repetition, would, in all probability, ulti- 
mately be sufficient to injure the strongest constitution. 

By attention to these precautions, those inflammatory diseases, for 
which cold only prepares the system, mav be easily avoided 



cough. 223 



C O UGH 

Is produced by the violent, and, for the most part, involuntary 
motion of the muscles of respiration. It proceeds from various 
causes, and is, therefore, as variously to be treated. 

The seat of every cough is generally in the breast, and the prin- 
cipal parts diseased, are the wind-pipe, and the ramifications, which 
are irritated by inflammation, obstruction, or when foreign bodies 
have been introduced ; but the morbid irritation may be in the adja- 
cent part, as the diaphragm, the stomach, the pleura, the oesophagus, 
the liver, &c. Thus, coughs attend pleurisies, wounds about the 
neck, inflammation of the liver, acrid matter in the stomach, or in 
the duodenum. Spasmodic disorders are often attended with a 
cough, the lungs suffering, either by consent from the source of the 
spasm, or becoming, in their turn, the seat of that which produced 
the spasm in some distant part. The most frequent cause, however, 
is suppressed perspiration. 

Coughs are generally, at first, dry; but at last, expectoration comes 
on, and a hectic fever is the consequence. It sometimes happens, 
however, that a cough continues during a long life, without incon- 
venience ; and though it does not lead to consumption, induces at 
last, asthma, or dropsy of the breast. 

So far as coughs are connected with the state of the lungs, they 
have already been considered under the head of cold, and will be 
farther noticed in treating of consumption, so that we shall here 
chiefly notice the symptomatic coughs. 

The cure of the symptomatic coughs depends upon the removal 
of the original disease : hence, the absolute necessity, in all chronic 
coughs, of investigating the cause before we can expect to find the 
appropriate remedy. 

Sometimes, coughs have their origin in the stomach, affecting the 
lungs by sympathy, in which case, recourse must be had to emetics, 
aperients, stimulants, and tonics, with the view of cleansing and 
strengthening the organ primarily affected. 

Should the liver be the seat of the disease, calomel in small doses, 
together with the nitric lac ammoniac, (see Dispensatory^) constitute 
the best remedies. 

It is very evident that coughs more frequently arise from hepatic 
affections than is generally suspected. The coughs of those who 
have long resided in warm climates, very generally proceed from a 
diseased liver. And we are fully persuaded those cases of hectics 
which have been cured by salivation, originated from scirrhus of 
that viscus. 

Women, in the last months of pregnancy, are sometimes afflicted 
with a troublesome cough, but which will readily yield to small 
bleedings, at the same time keeping the bowels in a soluble state, 
and avoiding food indigestible and of a flatulent nature. 



224 cough. 

With children, a cough is occasionally produced by teething, as 
well as by worms ; in both of which cases, it is to be cured by such 
medicines as are adapted to those complaints. 

Coughs which attend the dyspeptic, chlorotic, and hysteric habits, 
are styled ne? v vous. In this, as in other convulsions, increased irri- 
tability, with a less evident stimulus, or sometimes with a stimulus 
which escapes observation, induces a violent degree of the complaint. 
It is supposed, cough of this kind proceeds from repelled eruption, 
gout, or the translation of some disease to the lungs. In such cases 
much benefit will be derived from the warm and vapour bath, and 
when the secretion of the chest is greatly lessened, and debility 
alone remains, we must endeavour to give tone to the system, by 
substituting the cold for the warm bath ; by administering the cold 
infusion or decoction of bark ; by tranquillity of mind ; by moderate 
exercise, together with a nourishing and generous diet. It is neces- 
sary, however, to observe, in having recourse to the cold bath, should 
the patient feel chilly and uncomfortable, instead of feeling a uni- 
versal glow over the system and being invigorated, it must not be 
repeated until the visceral obstructions are removed. Neither will 
it be proper to continue the use of the bark or any other tonic, if it 
be found to check expectoration, or produce a difficulty of breath- 
ing. In several instances of unconquerable coughs of this kind, 
which have come under my notice, calomel, united with squills, or 
given alone in small doses to produce ptyalism, has effected a cure. 
The operation of calomel in the cure of obstinate coughs is, by 
producing a determination to the liver, and thus, by an increased 
secretion from that organ, securing more the vital parts and relieving 
those affected, and by exciting a new and general action in the 
arterial system, which shall transcend or supercede the existing 
morbid action. 

When the cough is kept up entirely by irritation, arising from an 
increased secretion of mucus, under a weakened state of the lungs, 
a dose of paregoric at bed-time, will prove exceedingly beneficial ; 
so the occasional use of some of the pectoral mixtures. (See Dis- 
pensatory.) In this state, where inflammatory action has totally 
ceased, some of the balsamic medicines may also be employed with 
safety and advantage, and of these the tolu is the most valuable. It 
is a very grateful medicine, in consequence of its fragrant smell, and 
having a warm, sweetish taste. The dose of the tincture, or syrup, 
to adults, is a tea-spoonful, in some mucilage or syrup, three or four 
times a-day. Dr. Hill's balsam of honey is nothing more than the 
tincture of tolu sweetened with honey. Tar united with bark, and 
formed in pills, have been administered in doses of six or eight three 
times a-day, with very good effects. In like manner, tar-water, 
taken, to the quantity of a quart daily, has been found useful in 
coughs of long continuance. 

In coughs of aged people, or in all cases where the lungs are 
heavily oppressed, and expectorations difficult, gum ammoniac in 



cough. 225 

doses of ten or fifteen grains dissolved in mint water or ginger tea, 
or administered in the shape of pills, or, which is preferable, given 
in the form of the nitric, lac ammoniac, (see Dispensatory^) will 
not fail to produce expectoration and abate the distressing fatigue 
of cough. 

From the variety of causes which produce coughs, it must be 
evident the mode of treatment should vary ; and here we would 
earnestly entreat every one who values the preservation of health 
never to trust for the cure of any complaint, more especially affec- 
tions of this kind, to patent medicines. Let it be impressed upon 
their minds, that most of those advertised, as infallible remedies for 
the cure of colds and coughs, are either perfectly inert or really 
hurtful. And, even supposing the medicine employed to possess the 
virtue ascribed to it by the proprietor, can it be applicable to all the 
various forms and stages of the complaint for which it is recom- 
mended? If in one stage of a disease, judiciously administered, it 
prove a successful remedy, in another it must of consequence be in 
the highest degree injurious. (See Preliminary Observations.) 

By resorting to medicines of this description, they frequently let 
slip the favourable opportunity, when, by more rational means, their 
health might have been easily restored ; and their complaint thus 
gaining ground, under the use of an ineffectual nostrum, will often 
become inveterate in its nature, and set all human skill at defiance. 

How lamentable it is that so many valuable lives are yearly sacri- 
ficed by persisting in the use of quack medicines. 

It is to the credulity of the lower class of society, that they are 
most liable to be taken in by the infamous venders of poison, since 
they very generally prefer the use of a patent medicine to the advice 
of a practitioner. But how astonishing it is to find this fatal pre- 
possession extend farther! for we have frequently observed persons 
of higher order, and who it was expected would have had better 
understanding, persist in their use, and become a sacrifice to the 
delusion. 

When the liver is the seat of disease accompanied with cough, the 
following powders will be found beneficial. Nitre, one drachm. 
Calomel, six grains. Opium, three grains. Ipecacuanha, six grains. 
To be divided into six powders. One should be taken every three 
hours. 

When great debility attends cough, the following mixture will be 
serviceable. Of gum assafoetida, half a drachm. Solution of the 
acetate of ammonia, two ounces. Mint- water, two ounces. One 
tea-spoonful for children and one table spoonful for adults. 

When inflammatory action has subsided, the balsams may be given 
as follows. Of balsam copaiva, half an ounce. Balsam tolu, half 
an ounce. Powdered gum Arabic, half an ounce. Aromatic sul- 
phuric acid, fifty drops. Distilled water, six ounces. One table 
spoonful is the dose every three or four hours. 

Or this: Tincture of tolu, an ounce and a half. Aromatic sul- 
29 



226 EPIDEMIC. 

phuric acid, two drachms. Tincture of digitalis, two drachms. An- 
timonial wine, two drachms. Honey, an ounce and a half. Pow- 
dered liquorice root, half an ounce. Distilled water, six ounces. A 
table spoonful for a dose according to circumstances. 

When expectoration is difficult, the following mixtures have 
proved of signal benefit. Gum ammoniac, two scruples and a half. 
Nitric acid, two drachms. Fountain water, eight ounces. Pour the 
nitric acid and water together, then add the compound gradually to 
the gum, mixing them well in a composition mortar. Dose, a table 
spoonful three or four times a-day. 

Infusion of Flax-seed. — Take of flax-seed pounded, one 
ounce. Liquorice root, half an ounce. Boiling water, two pounds. 
Let it rest two or three hours near the fire in a covered vessel. Strain 
and add lemon juice enough to make it pleasant. 

Decoction of Iceland Moss. — Take of Iceland moss an ounce. 
Fountain water, one pint and a half. Boil to one pint and strain 



EPIDEMIC 



The attention of the medical gentlemen of our country, was 
drawn to a disease, which, during the last three winters, pervaded 
every State in the Union ; and in most of them, according to the 
statements of the physicians, assumed every variety of shape, and 
required no little diversity of treatment. In some places, the lancet 
was used freely ; and in others, remedies highly stimulant were ad- 
ministered. In spite, however, of the very different practice pursued, 
the disease continued its ravages, which, in many places, resembled 
those of the plague, sweeping whole families into the grave. 

Extreme debility appears to have been the characteristic feature 
of the disease; for all accounts agree, that in whatever form it com- 
menced, there ensued a great, and sometimes, a very sudden prostra 
tion of strength. 

This alarming pestilence did not appear in the city of Washington, 
until the winter of the year 1815 ; and even then, not so destructively 
as in many other places. Most of the cases which I saw, resembled 
very much the bilious pleurisy of our country. They commenced 
with chill and fever, accompanied with pain in the side and chest, 
with a dry skin and rather laborious respiration. But the cough 
was by no means so frequent and distressing as in pleurisy or perip- 
neumony. The eyes were wild and red, the countenance uniformly 
indicated great anxiety and distress. In some instances the throat 
and head were very much affected. The pulse was full, though 
soft, and readily compressible; indeed it sometimes indicated so 
much action that a practitioner not conversant with its peculiarity of 



EPIDEMIC. 227 

type, would be very apt to treat the complaint as an inflammatory 
affection. This counterfeit character, however, did not continue 
long, for in a very short period it assumed the typhoid form. 

Of the causes of the disease little has been ascertained. In com- 
mon with other epidemics, its origin is involved in obscurity. As yet, 
we know only that it commences in cold weather, and is generally 
dissipated by the warmth of spring. 

In the treatment of those cases which came under my care, I 
generally commenced with an emetic ; and if this had no effect 
on the bowels,, it was followed by a dose of salts, or an infusion of 
salts, senna and manna. During the operation of the cathartic, I 
sometimes found it necessary to support the patient, by having wine 
added to the gruel with which the medicine was to be worked off. 
As the cure of this formidable disease depended principally on 
exciting perspiration, I lost no time, after the operation of the medi- 
cine, in having sudorifics administered ; and of this class, I found 
nothing superior to the seneca and Virginia snake-root. (See Materia 
Medica.) In the incipient stage of this disease, I directed a strong 
decoction of the former to be taken in doses of a tea cup full every 
hour or two, and as the disease advanced, or the pulse began to sink, 
the latter was administered in the same manner. In addition to this, 
mulled wine or cider highly spiced, or hot toddy, was given very 
freely, in those cases which indicated great prostration of power. It 
was also my uniform practice, to have a blister applied as speedily 
as possible on the breast or side, over the pained part. If the head 
were most affected, the blister was put between the shoulders : and 
when the throat was complained of, a cataplasm of mustard or garlic, 
(see Materia Medica^) was applied around the neck. Flannels, 
wrung out of hot spirits, in which mustard-seed or red pepper had 
been steeped, were constantly applied to the extremities, and assisted 
greatly in producing the desired effect. 

As the disease advanced, bark, conjoined with Virginia snake-root, 
proved a useful auxiliary in facilitating the cure. 

Dr. Cutbush pursued a very similar plan, in the treatment of his 
patients, with the same fortunate result. 

Many other practitioners bear testimony in favour of this mode 
of practice. The ingenious and learned Professor Chapman, in his 
very interesting lecture on this epidemic, which I had the pleasure 
of hearing, stated, that, in no instance, did any patient die under his 
care, after perspiration was induced. It was his practice, also, to 
combine with the diaphoretics, the most cordial stimulants ; and of 
this class of remedies, he spoke highly of volatile alkali, in frequent 
and large doses. 

As malignant as this disease was, it appeared to pay some respect 
to persons. For the rich, or rather those who lived generously, 
were seldom attacked with it; while the poor, and the intemperate, 
in those places where its ravages were most destructive, hardly ever 
escaped. 



228 



PHRENSY, 



PHRENSY, 

OR INFLAMMATION OF THE BRAIN. 

Symptoms.— A deep-seated headache, redness of the eyes and 
face, violent throbbing- or pulsation in the arteries of the neck and 
temples, incapability of bearing light or noise, a constant watching 
or delirium, with picking of the bed-clothes. The pulse, although 
sometimes languid, is generally hard, tense, and strong. The mind 
chiefly runs upon such subjects as have before made a deep impres- 
sion upon it ; and sometimes, from a sudden silence, the patient 
suddenly becomes delirious and quite outrageous. 

An approaching Phrensy is announced by intense continual watch- 
ings ; or, if the patient sleeps, his sleep is interrupted and troubled : 
he starts, and is affected with terrible dreams, soon forgetting what is 
said. If, at any time, he returns an answer to a question, his fierce- 
ness and anger seem to be increased ; a pain is constantly felt in the 
back part of the head, and, as the disorder increases, the eyes be- 
come more fixed and red, tears at the same time flowing from them. 
The tongue is dry, rough, and of a yellow or black colour, the face 
of a deep red, and the pulse small, quick, and hard. 

Phrensy is distinguished from mania, by the sudden attack, the 
violent fever, pain in the head, and an evident exciting cause ; and 
from that species of delirium which occurs in low fevers, unaccom- 
panied with inflammation, by the appearance of the countenance 
and eyes ; for, in true phrensy, the features are rather enlarged than 
shrunk, and the eyes are protuberant and sparkle ; whereas, in the 
delirium supervening to low fever, the face is pallid, the features are 
shrunk, and the eyes pearly. 

Causes. — Exposure of the head to the scorching rays of the sun ; 
to deep and long continued thinking ; excessive drinking 5 suppres 
sion of usual evacuations ; concussion of the brain, and whatever 
may increase the afflux of blood to the head. 

Treatment. — Blood-letting is the " anchor of hope" in this dis- 
ease, which should be employed copiously on its first attack, and 
repeated as the symptoms and strength of the patient will permit. 
Immediately after bleeding, a dose of calomel, followed by a large 
dose of salts, or some cooling purge must be given. Ice pounded 
and put into a bladder, or folds of cloth wet with vinegar or cold 
water, should constantly be applied to the head and temples ; and if 
the symptoms prove obstinate, the head ought instantly to be shaved, 
and the whole of the scalp covered with a blister. When the pulse 
has been reduced by blood-letting from the arm, if the pain in the 
head continue severe, let cups or leeches be forthwith applied to the 
temples, forehead, and back of the head. 

Bathing the feet and legs in warm water, or wrapping them up in 



PHRENSY. 229 

flannel wrung out of hot water, is also of great service, by producing 
a revulsion of blood from the head. With the same view, sinapisms 
and blisters should be employed. 

One of the antimonial or camphorated powders, (see Dispensatory,) 
given every two hours, or large portions of nitre dissolved into the 
patient's drink, will be useful. 

If the disease be occasioned by a sudden stoppage of evacuations, 
every means to restore them must be tried. In all inflammatory 
affections of the head, a copious discharge from the intestines will 
be found highly beneficial, by diverting the humours from the 
head; and when we cannot employ purgatives, laxative clysters 
should be used. 

To assist also in diminishing the determination of the blood to the 
head, the patient should be kept as near the erect posture as can 
easily be borne. 

In symptomatic phrensy, particular attention should be paid to the 
primary disease which has given rise to it, and the treatment ought 
to be varied according to the nature and progress of the disorder 
which has occasioned it. In its early or inflammatory stage, copious 
bleeding will be necessary ; but if it has been of some continuance, 
drawing blood from the temples, by means of leeches, or cupping 
with scarifications will be preferable. The application of a blister 
to the neck or between the shoulders is not to be omitted, as it is well 
adapted, by keeping up a steady discharge, to lessen the accumula- 
tion. When the accumulation is removed, its effect, unsteadiness 
of mind, often continues. This is sometimes supposed to be owing 
to remaining inflammation, and the violent evacuations are with 
little discrimination employed ; a plan which increases instead of 
mitigating the disease ; for it depends on the too great previous ex- 
citement. We have found no mode of conduct particularly service- 
able, except absolute rest of mind, with moderate exercise of body. 
The camphor, bark with valerian, and some other medicines of this 
tribe, with cold bathing, and gentle alvine evacuations, seem occa- 
sionally to have contributed to the relief ; but from time alone a cure 
may be expected. 

Regimen. — The diet should be of the lightest kind, as ripe fruits, 
with diluent drinks, such as cold water, tamarinds and water, (fee, 
freely used. The patient to be kept in a dark room, as cold and 
quiet as possible, avoiding all irritating causes, and breathing a cur- 
rent of fresh air. # 

* It was of this disease, generally termed a stroke of the swi, that the brave 
General Greene, an officer second only to Washington, died at Mulberry 
Grove, his country seat near Savannah. A true republican, he delighted in 
exercise, particularly that of gardening, of which he was so fond as sometimes 
to continue it under the meridian blaze. It was in this garden that the last 
summons found him. His honourable friend, E. Telfair, Esq., had often 
cautioned him against imprudent exposure to the Georgia sun : but believing 
that he possessed the same nerves that sustained him on the hot field ot 
Monmouth, he still pursued his favourite exercise : but while busily adorning 



230 QUINSY, OR INFLAMMATORY SORE THROAT. 

QUINSY, 

OR INFLAMMATORY SORE THROAT. 

Symptoms. — Is distinguished by a sense of heat, pain, and tight- 
ness in the fauces and throat, accompanied by a difficulty of swal- 
lowing, particularly fluids. In general, the inflammation begins in 
one tonsil, a gland on each side of the palate, then spreads across the 
palate, and then seizes the other tonsil. When the inflammation 
possesses both sides, the pain becomes very severe, and swallowing 
is performed with extreme difficulty ; but if it attack the upper part 
of the windpipe, it creates great danger of suffocation. 

Causes. — Cold, wet feet, throwing off the neck-cloth, or drinking 
cold water when over-heated. 

Treatment. — The same rules are to be observed, in this as in 
all cases of disease highly inflammatory, such as bleeding, purging, 
and other cooling means. The extent to which these are to be used, 
can only be ascertained by the violence of the disease and the con- 

the soil which his own valour had so gloriously defended, a sunbeam pierced 
his brain, and in a short time translated to heaven as noble a spirit as ever 
fought under the Standard of Liberty. 

In 1818, the medical community lost, by this inexorable disease, John 
Syng Dorsey, M. D., who, by his acquirements and performances, had at- 
tained to very great distinction, as a physician and teacher. Having been 
adjunct professor of surgery, with his venerable uncle, Dr. Physick, in the 
medical school of Philadelphia, and filled with brilliancy, the chair of materia 
medica, he was unanimously elected to the chair of anatomy, as successor of 
Professor Wistar; and, but a few days before his lamented death, had deliv- 
ered, with great eclat, his introductory lecture to his intended course. The 
chair, to which he had been promoted, was long filled by Dr. Shippen and 
Dr. Wistar; with what success and popularity, need not here be particularized. 
The generous and benevolent Shippen has always been accounted one of the 
fathers, and Wistar not the less magnificent pillar of the scientific edifice, 
which has contributed a full share of glory to our nation. — The immediate 
predecessor of Dr. Dorsey was admired, not only for his professional qualities, 
but for his charming social virtues, and uniformly dignified, and polished hos- 
pitality. His house was wide open as the benevolence of his heart ; and his 
daily companies comprised the learned of our country, and the enlightened 
visiters from Europe. On his death, he left vacant the chair of anatomy in the 
University of Pennsylvania, and the presidency of the American Philosophical 
Society. To the former, Dr. Dorsey, one of his favourite pupils and hourly 
companions, was unanimously elected, and carried with him the confident 
expectation of every one, that it would not only be reputably sustained, but 
adorned by his various genius, attainments, and popular eloquence. To say 
nothing of the great disappointment which his very sudden death created in 
the University, extending alike to the trustees, faculty, and students, we should 
have left more than enough to fill up this passing tribute of a friend, in the 
recollections of the infinitely varied attractions of his private character. He 
was manly and generous; kind and benevolent; honourable and faithful; gay 
and good-natured ; instructive and entertaining, and died, as all like him, 
deeply and universally regretted. 



QUINSY, OR INFLAMMATORY SORE THROAT. 231 

stitution of the patient; but, from the danger of this complaint, they 
should be early and freely employed, particularly if there exist any 
fever. 

Local applications have also their good effects, and in slight cases, 
are often sufficient to remove the inflammation. Receiving the 
steams of warm water, or vinegar and water, through a funnel or 
spout of a tea-pot, will give great relief. Much benefit may be de- 
rived from the use of gargles, commencing with the common and, 
after the inflammation is considerably abated using the astringent 
gargles. (See Dispensatory.) At this stage of the disease gargles 
of port wine, or brandy and water, answer every purpose, to restore 
the tone of the fibres, relaxed from over distension. 

External applications are, likewise, of great use. In slight cases 
it will be sufficient to have the neck rubbed twice or thrice a day 
with the volatile or camphorated liniment, (see Dispensatory,) and 
a piece of flannel applied. The embrocation will be rendered still 
more stimulating by adding a small portion of the tincture of can- 
tharides. But in those cases where the inflammation is considerable, 
the early application of leeches, or a blister or cataplasm of mustard 
around the neck, is most to be relied on ; which, by exciting exter- 
nal inflammation, will lessen the internal. Onions, (see Materia 
Medica,) are also excellent when applied externally in this disease. 

In addition to these remedies, the antimonial mixture, or decoc- 
tion of rattle-snake root, (see Materia Medica}) given in such 
doses as will excite perspiration, is much to be depended on, when 
the inflammatory symptoms run high, and before the febrile symp- 
toms are at all violent, the timely exhibition of an emetic often 
proves extremely useful, sometimes checking its complete formation. 

Should these means prove ineffectual, and there appear a tendency 
to suppuration, it ought to be promoted by frequently taking into the 
fauces the steam of warm water, or applying warm poultices to the 
neck. As soon as a whitish tumour with fluctuation of matter is 
discovered, it should be opened by the lancet, and then the detergent 
gargles, (see Dispensatory}) should be used. If in consequence of 
the largeness of the tumour the patient cannot swallow, he must be 
supported by nourishing clysters of broth, gruel, or milk. 

If persons, as soon as they discover any uneasiness in the throat, 
were to use the nitrous lozenges, (see Dispensatory}) or small por- 
tions of nitre, as recommended under the head of cold ; bathe their 
feet in warm water ; apply flannels moistened with one of the above 
liniments ; and keep comfortably warm, this disease would seldom 
proceed to a great height. 

Regimen. — With respect to the regimen, it must be of the cooling 
kind, except the application of cold. Barley or rice-water, flax-seed 
tea, and such like, rendered agreeable to the palate by the addition 
of jelly or honey, should be often taken, although difficult to swal- 
low : for the pain consequent on swallowing is more owing to the 
action of the inflamed parts, by which deglutition is performed, than 
by the passage of the liquid which is swallowed. 



232 PUTRID SORE THROAT. 

Prevention.— For the prevention of this disease, the directions 
should be adverted to, which have been given under the head of 
cold. Where it becomes habitual, an issue behind the neck will 
often succeed in preventing its recurrence.* 



PUTRID SORE THROAT. 

This is a contagious disease, and appears more generally in 
autumn, after a hot summer. It oftener attacks children, and per- 
sons of relaxed habits, than those of vigorous health. 

Symptoms. — It generally comes on with a sense of giddiness, 
such as precedes fainting, and a chilliness or shivering like that of 
an ague fit, soon followed by a great heat, interchangeably succeed- 
ing each other during some hours, till, at length, the heat becomes 
constant and intense. The patient then complains of an acute pain 
in the head, of heat and soreness in the throat, stiffness of the neck, 
anxiety and nausea, with vomiting and delirium. On examining 
the mouth and throat, the uvula and tonsils appear swelled, and are 
of a deep red, or shining crimson colour ; soon after covered with 

* Well knowing how deep an interest the world always takes in great men, 
I trust it will not prove unacceptable to my countrymen, to learn that the 
above malady, the Quinsy, was the messenger whereby God was pleased to 
introduce into his own presence, the soul of that purest of human beings, 
George Washington. 

On the afternoon of the 13th December, 1799, riding out to one of his farms, 
he was caught in a driving rain, which soon turning into a snow storm, de- 
posited a considerable quantity of snow betwixt his cravat and neck. Long 
accustomed to brave the inclemencies of weather, he paid no regard to this 
circumstance ; but having brushed off the snow on his return, he supped and 
went to bed, as usual. Some time before day, he was awakened with the sore 
throat, and difficult breathing, which constitute quinsy. A faithful domestic, 
who always carried a lancet, was called up and bled him, but without afford- 
ing any relief. About day break, my near relative and honoured preceptor 
Doctor James Craik, of Alexandria, the inseparable friend and physician of 
Washington, was sent for, who reached Mount Vernon about ten o'clock. 
Alarmed at the general's symptoms, he communicated his fears to Mrs. Wash- 
ington, who immediately despatched servants for Doctors Dick and Brown. 
Nothing was omitted that human ingenuity and skill could do for a life so 
dear, but all in vain. It appeared, in the result, as the illustrious sufferer pre- 
viously declared, that his hour was come. 

To oblige Mrs. Washington, he continued to take medicines offered him, 
till the inflammation and swelling obstructed the power of swallowing ; when 
he undressed himself and went to bed, as he said, " to die." About half an 
hour before he died, he desired his friends to leave him, that he might spend 
his last moments with God. Thus, after filling up life with glorious toils, ha 
went to rest, "in a good old age, ladened with riches and honour" 

" Let the poor witling argue all he can, 
"It is religion still that makes the man." 



PUTRID SORE THROAT. 233 

white or ash-coloured spots, which, in a short time, become ulcerated. 
The pain in swallowing is slight, in proportion to the degree of in- 
flammation. The patient often complains of an offensive putrid 
smell, affecting the throat and nostrils, sometimes occasioning nausea, 
before any ulcerations appear. On the third day, or thereabouts, a 
scarlet eruption is generally thrown out on the skin ; first, on the face 
and neck, and then, over the whole body and extremities. 

Prom the first attack of the complaint, there is considerable fever, 
with a small, frequent, and irregular pulse; and every evening, there 
appears a manifest exacerbation, and in the morning some slight 
remission, together with a debility and general loss of strength. 

In slighter kinds, the course is not very different from that of the 
inflammatory species, though seemingly slight,, with alternate chills 
and heats, pain in the head, &c, till the debility appears, when every 
other bad symptom immediately follows. Every sore throat should, 
therefore, be carefully examined. 

The putrid sore throat sometimes attends on measles which are of 
a malignant nature. 

In a disease which runs its course generally in less than five, 
always in seven days, no prognostic is to be depended on ; but a 
more florid appearance in the throat, and a more healthy aspect of 
the edges of the sores. 

Causes. — The same which give rise to the nervous or putrid 
fever, as bad air, damaged provisions, &c, &c. 

Treatment. — The indications of cure are similar to those of the 
nervous or malignant fever, as it is analogous in some essential cir- 
cumstances to that disease : to which we must add the healing of 
the ulcers. 

Therefore, on the first attack of the putrid sore throat, an emetic 
may be given, which may be repeated on the next day, and followed 
by a mild cathartic. Afterwards it will be necessary to recruit the 
patient with bark and wine, or milk toddy. 

The ulcers in the throat demand early and constant attention, as 
a loss of substance here cannot but threaten much danger to life, or 
injury to the parts, if the patient should survive : hence, the use of 
gargles must be obvious to every one. When the disease is of a 
mild aspect, the common and astringent gargles, (see Dispensato- 
ry^) frequently used, are often sufficient : but when the symptoms 
are urgent, the tendency to putrefaction great, the sloughs large, and 
the breath offensive, the detergent gargle must immediately be re- 
sorted to. Independently of gargling the throat, it is essential that 
some of the same liquid be injected in the fauces, with a small 
syringe. 

In young subjects, this method is the more necessary, as they do 
not know how to manage a gargle to any purpose, did the soreness 
of the parts permit them to do it. 

When the throat is painful, the application of a piece of flannel 
moistened with the volatile liniment, spirits of camphor, or tincture 
30 



234 PUTRID SORE THROAT. 

of red pepper, to excite a slight degree of inflammation externally, 
will be attended with good effect. But blisters, from the prevailing 
disposition to putrefaction, must be carefully avoided. 

According to Dr. Currie, the affusion of cold water is also bene- 
ficial in this disease. It was his practice, after a copious affusion, to 
have his patient wiped dry and put into bed, and given about eight 
ounces of wine, if an adult, and so in proportion to children ; which 
plan, it appears, was very successful ; for in fifty out of sixty-two 
cases, where he had adopted it at the commencement of the disease, 
he succeeded. 

Dr. Thomas states, that, when he was in the island of St. Christo- 
pher's, in the year 1787, this disease prevailed a universal epidemic 
among children, and a vast number of them fell martyrs to it, in 
spite of the utmost endeavours of the profession to save them ; when 
at last the most happy effects were derived from the use of a remedy, 
the basis of which was Cayenne pepper. The medicine was pre- 
pared by infusing two table-spoonsful of this pepper and a tea-spoon- 
ful of salt in half a pint of boiling water, adding thereto the same 
quantity of warm vinegar. After standing for about an hour, the 
liquor was strained through a fine cloth, and two table-spoonsful were 
given every half hour. 

The speedy and good effects produced by the use of this medicine, 
in every case in which it was tried, evidently point out the utility of 
giving warm aromatics, which will bring on a timely suppuration of 
the sloughs, as weil as other antiseptics, to correct the tendency in 
the pails to gangrene. Since the period above mentioned, many 
practitioners bear testimony in favour of Cayenne or red pepper, (see 
Materia Medical) in the putrid sore throat. Pepper-corns constantly 
bitten, and the saliva swallowed, have been highly useful. 

The grand objects to be kept in view, in this malignant disease, 
should be, to check or counteract the septical tendency which pre- 
vails, to wash off, from time to time, the acrid matter from the fauces, 
and to obviate debility. With this view, give quinine or bark, in 
large doses every two hours in ginger tea, or a strong infusion of 
Virginia snake-root. These may be washed down with punch, milk 
toddy, porter, or cider. It will be necessary, also, to make a liberal 
use of wine, which may be given to persons unaccustomed to it from 
one to three quarts within twenty-four hours. Even sleep is less 
necessary than wine and bark, and should it continue above three 
hours, the patient must be awakened, for the loss of time cannot be 
regained. The quantity of the wine and bark must be regulated by 
the effect. If we gain nothing in the first thirty-six hours, we may 
depend on a fatal event ; if we lose ground in twenty-four hours, 
our hopes will be inconsiderable. In addition to these remedies, we 
would earnestly recommend bathing the patient frequently in a strong 
decoction of oak bark, with one-fourth whiskey. This valuable 
remedy should always be resorted to with children, as it is often im- 
practicable to prevail on them to take medicine of any kind. It is 



FALLING OP THE PALATE. 235 

also advisable with such patients to administer this decoction in a 
clyster ; or use as an injection two drachms of Peruvian bark with 
a gill of thin gruel or barley-water, which should be given every 
three or four hours to young children ; and about half an ounce in a 
proportionate quantity of the liquid to those of eight or ten years of 
age. Should the first clyster come away too soon, from five to 
twenty drops of laudanum may be added to the subsequent ones. 

Should any particular symptoms arise during its progress which 
may tend to aggravate it, such as vomiting, diarrhoea, hemorrhage, 
or suppression of urine, the same remedies must be resorted to as 
advised under the head of Nervous Fever. 

Regimen. — Medicine will prove of little efficacy, if the animal 
powers be not supported by proper nourishment: the attendants 
must, therefore, constantly supply the patient with arrow-root, sago, 
panado, gruel, (fee, to which may be added, such wine as is most 
agreeable to the palate. 

Ripe fruits are peculiarly proper, and fermented liquors, as cider, 
perry, &c, should constitute the chief part of the patients drink. 
But previously to taking any nourishment, gargles and injections 
should be very carefully employed ; for cleansing away the sharp, 
acrid humour from the mouth and throat, to prevent, as much as 
possible, its being swallowed. The patient should be so placed in 
his bed, that the discharge may freely run out at the corners of the 
mouth, and great attention should also be paid to cleanliness. 

The feelings of a tender parent, who views the progress of the 
disease on a beloved child, cannot but excite our tenderest sympa- 
thy. Too often, from an ill-judged tenderness to the child, the pa- 
rent will not suffer this dreadful disease to be checked by medicines. 
But it should be remembered; that although the pain is for a moment 
increased by these harsh, but necessary means, yet the quantity of 
pain must, on the whole, be much lessened, and besides, which is 
the sweetest consideration of all, a precious life thereby saved. 

Prevention. — The same means as recommended in the nervous 
fever, to correct infectious air, must strictly be attended to here, and 
especially with a view to prevent the progress of this disease. 



FALLING OF THE PALATE. 

The falling down, or elongation of the palate, is attended with a 
sense of tickling in the fauces, and soreness at the roots of the tongue. 

Treatment. — Avoid speaking, and gargle the throat with the 
astringent gargle, (see Recipe 41,) or, when there is little or no 
inflammation, apply salt and pepper by means of the handle of a 
spoon. 



236 



MUMPS. 



If fever accompany this affection, bleed and give cooling purga- 
tives, using nothing but a vegetable diet. 

It is sometimes necessary to cut off a portion of the palate, to re- 
lieve the distressing cough which is produced by a long continuance 
of the disease. 



MUMPS. 

A contagious disease, affecting the glands and muscles of the neck 
externally. 

Symptoms. — Slight fever, which subsides upon the apppearance 
of a tumour under the jaw, near its extremities : sometimes only on 
one side, but more frequently on both. It increases till the fourth 
day, and then declines gradually. 

Treatment. — This disorder is often so slight as to require very 
little more than to use a spare diet, and keep a laxative state of the 
bowels. If, however, there be much fever and pain in the head, it 
will be necessary, in addition to the above, to bleed, blister behind 
the neck, and take freely of diluting drinks, as flax-seed tea, barley 
or rice water. 

It has been usual to keep the neck warm, but this is improper. It 
will be found generally, that those who have been most neglected, 
have been soonest restored to health. 

There is a singular peculiarity now and then attending this com- 
plaint ; for sometimes the swelling of the neck subsides, the testicles 
of the male, and breasts of the female, are affected with hard and 
painful tumours, and frequently when one or other of these tumors 
has suddenly been repressed, a delirium of the milder sort occurs. 
In this event, bleed moderately, apply a blister between the shoul- 
ders, give a dose of calomel, and endeavour to reproduce the swell- 
ing by warm fomentations and stimulating liniments. 

When these tumours are painful, every precaution should be used 
to prevent suppuration from ensuing, by bleeding, cathartics, anti- 
monial powders, or mixture, diluent drinks, and by cooling and dis- 
cutient applications, as cloths wetted with lead -water, (see Dispen- 
satory,) and cold vinegar and water. It is necessary, also, that the 
swelled testicle should be supported by a suspensory bag. 



SORE EYES. 237 



SORE EYES 



A. disease so well known as to render all description of it un- 
necessary. 

Causes. — External violence done to the eyelids, or to the eye 
itself ; extraneous bodies under the eyelids, as particles of dust and 
sand — acrid fluids or vapours — exposure of tne eyes to a strong light, 
and night watching, especially sewing, reading or writing by candle 
light. 

Inflammation of the eyes may also be the consequence of bad 
humours in the system, or may accompany other diseases of the eyes, 
and of the neighbouring parts, such as the turning inward of the 
eyelids, or styes growing on them. 

Treatment. — When the disease is moderate, and the exciting 
cause no longer exists, the cure is perfectly easy, requiring little more 
than external application, such as washing the eyes frequently with 
warm milk and water, mixed with a little brandy, or using for a 
lotion, mucilage of sassafras, (see Materia Medica,) simple rose- 
water, or about eight grains of white vitriol dissolved in a gill of 
spring water. 

But in more severe affections, bleeding, blistering behind the ears, 
on the temples, or nape of the neck, with gentle purgatives and the 
cooling regimen, will be found eminently useful. The greatest 
benefit will also result from soft linen bandages wet with cold water, 
applied to the eyes, and frequently renewed until the heat and in- 
flammation have subsided. Soon as this is effected, use the anodyne 
eye- water, (see Dispensatory,) or two or three drops of laudanum 
dropped into the eye, or bathe the eyes in cold water, or brandy and 
water to restore the tone of the parts. 

In all inflammations of the eyes from common causes, the remedies 
above specified will generally succeed ; only we should be careful 
not to use any of the more stimulant applications, till the inflamma 
tion begins to abate of its violence, otherwise they will rather in 
crease, than subdue the malady. 

In obstinate cases, there is no remedy so effectual as a blister 
plaster immediately over the eye. For this very important discovery, 
I am indebted to the adjunct professor of surgery, Dr. Dorsey, whom, 
on his own polite invitation, I accompanied to the hospital, where 
he showed me a case in point. A man, whose inveterate ophthalmia, 
after obstinately resisting all the usual applications, was completely 
cured by a single blister, about an inch and a half in circumference, 
employed in this novel way. 

When the pimples on the eye attend an inflammation and suppu- 
rate, they should be opened with the point of a lancet, and washed 
with the solution of white vitriol. 

If the eye remains very weak after the inflammation abates, the 



23S SORE EYES. 

best applications are the alum curd, (see Dispensatory^) which may 
be spread thinly on a rag, and applied over the eyes every night ; 
and a solution of alum in the proportion of a drachm to half pint of 
water; to which may be added the white of an egg. Bathing the 
face and eyes every morning in the coldest water, will also be found 
exceedingly useful. 

Sometimes the edges of the eyelids become swelled and ulcerated, 
and from the discharge puts on the appearance of fistula lachiymalis. 
When the disease is violent, an adhesion of the eye to the upper lid 
sometimes takes place, which should be carefully separated by raising 
the lid, and dissecting cautiously with a round-edged scalpel. In 
chronic affections of this kind, the application of an ointment pre- 
pared by mixing a scruple or half a drachm of white vitriol with 
half an ounce of fresh hog's lard to the eyelids, is sometimes alone 
successful ; but when the disease is violent, the mercurial ointment 
is required to give a more active stimulus. If the ulcers are not 
cicatrized by these means, the solution of blue vitriol, in the propor- 
tion of fifteen grains to an ounce of water, will be useful. Each 
application must be made by means of a camel-hair pencil, and the 
ointment softened by a gentle heat. When the ointments are used, 
they must be applied in the evening, and continue on the part all 
night; the solution must be used two or three times a-day, and the 
redundant fluid washed away with a syringe and a little cold water. 
Laudanum may occasionally be employed. In the general conduct 
of all these remedies, they should excite, on their application, a slight 
irritation, by which the puriform secretion is at first increased ; but 
by degrees the edges of the eyelids become soft, the glands lessen, 
the internal surface of the palpebral become smooth, and of its usual 
paleness. 

Inflammations are sometimes followed by specks on the eye, 
which if not early attended to, will obstruct the sight. They may 
be removed by daily blowing into the eye, through a quill, a little 
of the best loaf sugar, finely powdered. When this does not succeed, 
unite to the sugar an equal quantity of white vitriol or tutty, finely 
levigated, or blow calomel into the eye. 

When this disease is occasioned by morbid humours in the habit, 
as the scrofulous or venereal, we must use the remedies pointed out 
in the treatment of those complaints. If dirt or foreign matter be 
lodged in the eye, it may soon be removed by passing a small hair 
pencil between the eyelids, and the ball of the eye. 

The defending of the eyes from the light by confinement in a 
dark room, or wearing a piece of green silk over them, is a caution 
which, though too obvious to be pointed out, is too important to 
be omitted. 



■MH^HH 



OPHTHALMIA AND STRUMOUS OPHTHALMIA, OR SORE EYES. 239 

OPHTHALMIA, 

OR SORE EYES. 

Suppurative ophthalmia occurs in infants soon after birth occa- 
sioned by the mother being affected with leucorrhoea, or some morbid 
affection of the vagina. Leeching and mercurial purges are often 
found necessary — emollient fomentations with white poppy heads 
during the inflammatory stage. When the inflammation has sub- 
sided, the cloruret of lime, has been beneficial. Mr. Vartez has ap- 
plied this article in more than four hundred cases with success, in 
the proportion of one scruple to an ounce of distilled water. Another 
excellent application is the nitrate of silver three grains to an ounce 
of water. This is most serviceable when the discharge has become 
profuse and of a greenish colour. One grain of alum to an ounce 
of water or alum placed between two folds of soft linen may be used 
with advantage. The following solution has been attended with 
great success : Sulphate of copper and Armenian bole of each eight 
grains. Camphor two grains and add eight ounces of boiling water. 
A drachm of this must be mixed with an ounce of water, and in- 
iected forcibly under the eyelids. After the inflammation has been 
reduced, the powers of the patient must be sustained by tonics. 



STRUMOUS OPHTHALMIA, 

OR SORE EYES. 

After many years experience (says a distinguished writer) in the 
treatment of strumous ophthalmia and a trial of various remedies, I 
have found none as useful as the sulphate of quinine. In most of 
the little patients it acted like a charm. Dose one grain three times 
a-day. In very young children, half a grain. In this form of the 
disease, little reliance is to be placed upon astringent washes. Four 
grains of nitrate of silver to an ounce of distilled water has been 
found the most useful. A few drops to be let into the eye several 
times daily. When the disease is confined to the lids, benefit has 
been derived from the red precipitate ointment, fifteen grains to an 
ounce of lard and applied to the lids. Blisters in this form are often 
injurious. Setons in the nape of the neck are serviceable. 

Prevention. — To persons liable to this complaint the following 
instructions may be useful. When the eyes are weak, all painful 
and fatiguing exertion of them should be carefully avoided, such as 



240 PLEURISY. 

looking at the sun, sewing or reading by candle light, or sitting in a 
smoky room. 

If there be well grounded suspicion that the inflammation of the 
eyes originates from the suppression of any of the customary evacua- 
tions, these evacuations should, as soon as possible, be restored ; and 
until then, an issue or blister on the neck should be kept running, 
as a necessary substitute. 



PLEURISY. 

Symptoms. — An acute pain of the side, which reaches to the 
throat, in some to the back, and others to the shoulders, but, in gene- 
ral, is seated near the fleshy part of the breast, with a high fever, 
hard and quick pulse, difficulty of breathing, and a teasing cough, 
sometimes moist, but most frequently dry. The seat of the inflam- 
mation, and, consequently, of the pain, may vary in different cases, 
but this is not of much importance, as the same mode of treatment 
is required in inflammation of the viscera contained in the cavity of 
the chest, as the membrane which invests them. 

Causes. — The pleurisy, like other inflammatory diseases, proceeds 
from whatever obstructs the perspiration, as exposing the body to the 
cold air when over-heated. It may likewise be occasioned by what- 
ever increases the circulation of the blood, as violent exercise, or an 
imprudent use of ardent spirits. 

Treatment. — In the cure of pleurisy or inflammation of the 
viscera, our success depends on subduing the violent action of the 
vessels, by bleeding, blistering, and employing such remedies as are 
calculated to keep the bowels open, and to determine the fluids to 
the surface. 

Hence, at the onset of this disease, a large bleeding is always ne- 
cessary, succeeded by a dose of salts, senna and manna, castor oil, 
*or some cooling purge, and as long as the blood exhibits a sizy 
crust on its surface, when cool, and the violence of the symptoms 
continues, the lancet should be used once or twice a-day, with this 
exception, that, after a free expectoration has commenced, it will be 
less necessary. 

A blister over the pained part, after fche pulse has been reduced by 
bleeding, is by no means to be omitted; and if the pain be obstinate, 
when the blister on one side ceases to discharge freely, apply another 
on the other side. When blisters cannot be obtained , some substitute 
must be resorted to, as a cataplasm of mustard and vinegar. Warm 
cabbage leaves, or a bladder nearly filled with warm water, applied 
to the affected side, and repeated as often as it becomes cold, will 
sometimes afford a little relief. 



PLEURISY. 241 

During this treatment, the patient should take freely of warm 
diluent drinks, as flax-seed, balm, or ground ivy teas, barley or rice- 
water, to which may be added a little of the juice of lemons. 

The decoction of pleurisy, or seneca, or rattle-snake root, {see 
Materia Medica,) exhibited in doses of one or two table spoonsful 
every two or three hours, abates the febrile heat, and produces ex- 
pectoration. The antimonial powders or mixture, or camphorated 
powders, (see Dispensatory,) also produce these beneficial effects. 
When these medicines are not at hand, portions of nitre dissolved in 
the patient's common drink, and ipecacuanha exhibited in such 
doses as will keep up a nausea at the stomach, without vomiting, 
will answer every purpose. 

Inhaling the steam of hot water from the spout of a tea-pot, or 
applying a large sponge dipped in warm vinegar, to the mouth and 
nostrils, will be beneficial. Flax-seed syrup (see Materia Medica,) 
is a valuable medicine in this complaint, in allaying the cough, a 
symptom exceedingly distressing. When this is not convenient, 
make use of some of the pectoral mixtures, as advised under the 
head of cold. In the advanced stage of the disease, when the in- 
flammatory symptoms are almost wholly abated, and the cough 
proves the chief cause of pain and loss of sleep, then opiates may be 
given with the greatest advantage. 

It should be observed in the exhibition of opiates, that if they be 
administered in the commencement of inflammatory disease, before 
the necessary evacuations are made, they increase the inflammation, 
and, consequently, injure the patient; but, if given near the close of 
such maladies, they are of the greatest service, and complete the cure. 
When perspiration is obstructed, they should be coupled with some 
emetic drug, as in the form of the anodyne sudorific draught or bolus, 
(see Dispensatory ;) but when this is not the case, opium or lauda- 
num alone should be administered, and that in small doses, when 
the patient is much debilitated from previous evacuations. A half 
grain of opium, or fifteen drops of laudanum, or thirty drops of pare- 
goric, given about an hour before the evening exacerbation, alleviates 
the symptoms, and if repeated for a few evenings, gradually increas- 
ing the dose, ensures the cure. 

If the pulse sink and become languid, blister the extremities, and 
give six or eight grains of volatile salts every three hours with mulled 
wine. The bowels, in the course of the disease, must be kept mode- 
rately open, by emollient injections or mild laxatives, as castor oil, 
or the cathartic mixture. 

The bastard pleurisy is often confounded with true pleurisy. It 
consists of a rheumatic inflammation of the intercostal muscles, often 
of the other muscles, of the breast or abdomen. The disease is dis- 
tinguished by external soreness, and is relieved by bleeding, blister- 
ing, and exhibiting the seneca-root in decoction. 

Regimen. — In no disease is a strict abstinence more necessary 
than in this, since, in proportion to the nourishment taken, will be 
31 



242 PERIPNEUMONY, OR INFLAMMATION OF THE LUNGS. 

the increase of the blood, and consequently of fever. Nothing but 
diluent drinks, as toast and water, barley-water, bran, or flax-seed 
tea, ought to be allowed, until the violence of the disease is subdued; 
and these liquids should be taken often, but in small quantities at a 
time, and never cold. When nourishment is required, the lighter 
kinds only should be used, as arrow-root, sago, panado, &c. After 
recovery, great care must be taken to prevent a relapse ; the sparest 
diet should therefore be used; the inclemencies of the weather care- 
fully guarded against; moderate exercise employed, and the chest 
protected from the action of cold, by wearing flannel next to the 
skin. In this state of convalescence, a prudent use of wine with 
bark or Columbo, will assist digestion, and give tone to the system 
generally. 



PERIPNEUMONY, 

OR INFLAMMATION OF THE LUNGS. 

Symptoms. — Febrile affections, succeeded by difficulty of breath- 
ing, cough, and obtase pain under the breast bone, or betwixt the 
shoulders, increased on inspiration. A sense of fulness and tightness 
across the chest ; great anxiety about the heart, restlessness, loss of 
appetite and sleep ; the pulse quick, sometimes hard, and seldom 
strong, or regularly full ; the breath hot, the tongue covered with a 
yellowish mucus, and the urine turbid. From the obstruction to 
the free passage 0/ blood through the lungs, the veins of the neck 
are distended, the face swollen, with dark red colour about the eyes 
and cheeks. The pain in the chest is generally aggravated by the 
patient lying on the side most affected, and very often he can lie 
only on his back. 

Causes. — Cold, obstructing perspiration, and thus producing a 
morbid determination to the lungs, or violent efforts, by over- 
distension. 

Treatment. — Such is the delicate structure of the lungs, that 
they will not sustain inflammatory attacks many hours before their 
important functions are destroyed, or so much mischief produced as 
to lay the foundation of consumption. 

The antiphlogistic plan, therefore, as advised in the pleurisy, for 
the resolution of the disease, should be put into immediate operation, 
and not by degrees, as is often the case, by which many lives are lost, 
but should be carried to the utmost extent, particularly the taking 
away of blood in considerable quantities from the arm. 

We would remark, however, although the evacuating plan is in- 
dispensably necessary in the early stage of the disease, yet it should 



INFLAMMATION OF THE LIVER. 243 

not be continued too long ; for the truly salutary discharge is by 
expectoration ; and if the strength be too far reduced, this will be 
prevented. 



INFLAMMATION OF THE 
LIVER, 



Is of two kinds, the acute and chronic ; and, consequently, re- 
quires variations in the mode of treatment. 

Symptoms.— The acute is marked by a pungent pain of the right 
side, rising to the top of the shoulder, something like that of the 
pleurisy, attended with considerable fever, difficulty of breathing, dry 
cough, and often bilious vomiting. 

The chronic inflammation of the liver, is usually accompanied 
with a morbid complexion. The symptoms are sometimes very ob- 
scure, and confined rather to the common marks of stomach com- 
plaints, as flatulence and frequent eructations. The appetite, in 
consequence, fails, and occasional uneasiness or pain is felt in the 
region of the liver extending to the right shoulder, the characteristic 
of the disease. An obscure fever prevails, which is generally worse 
at night, inducing languor, want of sleep, and much oppression. 
The patient has generally clay-coloured stools, and high-coloured 
urine, depositing a red sediment, and ropy mucus. In the progress 
of the malady, the countenance seems livid and sunk, and the eyes 
of a dull white or yellowish hue. Under these symptoms, the body 
becomes gradually emaciated, while in the region of the liver, is felt 
a sense of fulness, with a slight swelling and difficult breathing, at 
tended with a hoarse, dry cough, particularly aggravated when the 
patient lies on the left side. 

As the disease advances, dropsical symptoms, accompanied with 
jaundice, supervene ; and under these complicated maladies, the suf- 
ferer sinks. Sometimes an abscess opens externally, which, if it do 
not effect a cure, at least prolongs the life of the patient. 

Causes. — Violent and repeated shocks from vomits ; sudden 
changes in the weather, but especially cold nights after very hot 
days ; sitting in a stream of air when over-heated ; drinking strong 
spirituous liquors, and using hot spicy aliment. 

In this complaint in its chronic form, the urine is highly tinged 
with bilious matter, and attended with a scalding sensation — tongue 
furred and dry — taste disagreeable — skin harsh and dry — short and 
dry cough — some difficulty in breathing — cannot rest with ease on 
the left side. As the disease advances, the patient becomes more 
and more thin and restless. When the round surface of the liver 



244 INFLAMMATION OF THE LIVER. 

is the seat of the disease, it is referred to the chest — -when the hollow 
surface is the seat the patient refers the pain to the stomach or 
bowels. In the chronic form, the following pills have been attended 
with good effect. Blue mass one drachm, extract of conium macu- 
latum half a drachm, ipecac one scruple make into thirty pills. 
Two morning, noon and night. Take calomel one scruple. Com- 
pound extract of colocynth two scruples. Tartar emetic one grain. 
Ipecac four grains. Castile soap ten grains. Oil of carui enough 
to make into eighteen pills. Two at bed time. 

To preserve the tone of the stomach and to regulate the action of 
the bowels, the following formula has been highly recommended by 
Dr. Johnson of London, Decoction of taraxacum four ounces, car- 
bonate of soda one drachm, extract of taraxacum two drachms. 
Tincture of gentian two drachms, mix and take two or three table 
spoonsful daily. The nitro-muriatic bath has been found servicea- 
ble in the following proportions. To eight ounces of water add 
four ounces of nitric and the same quantity of muriatic acid. One 
ounce of this mixture is to be used to a gallon of water. The feet 
and legs to be immersed in this mixture at the temperature of 96° 
twenty minutes on going to bed. If no pricking sensation is produced 
in the feet, more of the acid to be used. 

Treatment. — In this, as in all other cases of visceral inflamma- 
tion, the same means to take off inflammation, as advised in the 
pleurisy, should be carefully observed. And, as it is an object of the 
first importance to prevent the formation of matter, we should adopt 
these means as early as possible, to produce resolution, the only 
salutary termination. — Scarcely any complaint requires such prompt 
and copious blood-letting, as acute inflammation of the liver. After 
the acute stage is over, we may consider the affection of a chronic 
nature, and the mode of treatment must be regulated accordingly. 

In the chronic species of this disease, the cure depends principally 
upon mercury, which may be employed in the early stages of the 
complaint. The mercury may be introduced in the system, either 
by taking one or two of the mercurial pills, night and morning, or 
by rubbing as frequently on the part affected, the ointment about the 
size of a nutmeg, continuing the one or the other, until a ptyalism 
is produced or the disease is subdued. 

During this course, the use of the tonic powders, or pills, (see Dis- 
pensatory^) or bark and snake-root, when febrile symptoms have 
abated, will greatly hasten the cure. 

The nitric acid, with patients who are scorbutic, or much debili- 
tated, is far preferable to the calomel, on account of its antiscorbutic 
and tonic powers. It should be given to the extent of one or two 
drachms daily, diluted with water, in the proportion of one drachm 
of the acid to a quart of water. At first, it ought to be given in 
small doses, and frequently repeated, and the dose, gradually in- 
creased, as circumstances require. This medicine, like calomel, 
must be continued until the mouth becomes affected, the salivary 



INFLAMMATION OF THE STOMACH. 245 

glands enlarged, and their secretion increased ; and when this takes 
place, the disagreeable symptoms will be removed, and the patient, 
from being debilitated, becomes healthy, vigorous, and cheerful. 

My own experience of the efficacy of the nitric acid in chronic 
affections of the liver induces me to speak well of it; and I am hap- 
py to add it was a favourite remedy of that celebrated anatomist, and 
distinguished physician, Professor Wistar, in this distressing disease, 
particularly when there was an enlargement of the liver. 

Obstructions and indurations of the spleen, bear some resemblance 
to a diseased liver, and are very prevalent in low, marshy and aguish 
situations. Their treatment consists in the use of the same means 
recommended for the cure of this disease. 

Regimen. — The food should be easy of digestion, such as veal, 
lamb, fowls, or fresh beef. Water-cresses, garlic and other pungent 
vegetables are useful. A change of climate, and moderate exercise 
in the open air of the country, is both agreeable to the patient and 
very salutary.* 



INFLAMMATION OF THE 

STOMACH. 

Symptoms. — Acute pain in the stomach, always increased upon 
swallowing even the mildest drinks. Inexpressible anxiety, great 
internal heat, something like heart-burn, constant retching to vomit; 
and, as the disease advances, the pulse becomes quick and intermit- 

* Of this formidable disease, died, on the 29th October, 1823, Charles 
Carroll, of Bellevue, Maryland. This inestimable friend was extensively- 
known, and wherever known, was justly esteemed for his intelligence and 
moral excellence. Whatever of manly grace and virtue belongs to the human 
character, shone conspicuously in him. An affectionate husband and a kind 
parent, a generous friend and a polished gentleman ; he stood among his fel- 
lows, a bright example of what a man should be. His philanthropy prompted 
him to devote a considerable portion of his fortune, which was at one time 
ample, to the alleviation of the distresses of his fellow men. In more than 
one instance, as the author is able to testify, individuals owed much of their 
prosperity and happiness in life to his unsought bounty. Soon after the late 
war, Mr. C. removed from this city, where he had resided several years, to 
Genesee, New York. Early in the year 1822, he was induced to accept an 
office under the government of the United States, in Missouri. In that state. 
he contracted the disease, which, eighteen months afterwards, terminated 
fatally; and there, too, by a calamitous coincidence, his amiable and accom- 
plished son, Henry Carroll, (formerly private secretary to Mr. Clay, while 
minister at Ghent,) met with an untimely and violent death. The memory 
of Mr. Carroll's worth is deeply engraven on the hearts of all who knew 
him, and his name will, hereafter, stand high in the annals of virtue and 
benevolence. 



246 INFLAMMATION OF THE STOMACH. 

ting : frequent hiccoughs, coldness of the extremities, and the patient 
is soon cut off. 

Causes. — Acrid or hard and indigestible substances, strong eme- 
tics, or corrosive poisons taken into the stomach, or drinking ex- 
tremely cold liquors, while the body is in a heated state. It may > 
also be occasioned by external injury. 

Treatment. — Unless the inflammation can be resolved in the 
very beginning, it rapidly terminates in a mortification. 

Therefore, a violent pain in the region of the stomach, with sick- 
ness and fever, should always be very seriously attended to. Copious 
and repeated bleedings, not regarding the smallness of the pulse, are 
absolutely necessary, and is almost the only thing that can be de- 
pended on. In no inflammation is the immediate use of the warm 
bath so necessary as in this, which attacks at once the " throne" of 
life. If a better bathing vessel cannot be had, a barrel or half hogs- 
head, filled with warm water, about blood heat, will do. Let the 
patient be instantly put in it, covering the top with a blanket. Keep 
him in as long as he can bear it, and when taken out and wiped dry 
with warm cloths, he should immediately have a large blister or ca- 
taplasm over the stomach. The bowels must be kept open by the 
mildest clysters, as water gruel, or weak broth, with the addition of 
a little saltpetre, and sweet oil or sugar. These injections answer 
the purpose of internal fomentations, and also nourish the patient, 
who is often unable to retain any food, or even drink, upon his 
stomach. 

The ery thematic inflammation of the stomach often arises in putrid 
diseases, and comes on insidiously. It is evident, by the inflamma- 
tion appearing on the internal surface of the mouth. When, there- 
fore, an inflammation of this kind affects the mouth and fauces in 
the bilious, typhus, or puerperal fevers, with a frequent vomiting, 
and an unusual sensibility in the stomach, we may suspect that the 
same affection extends downward. In such cases, or when the 
state of inflammation is approaching to gangrene, spirits of turpen- 
tine, in doses of a tea-spoonful, given alone or in a little water, upon 
the high authority of Professor Chapman, will arrest the disease. — 
This medicine is to be repeated, more or less frequently, according 
to the urgency of the symptoms. When the disease is a little alle- 
viated, the infusion of bark, with a few drops of any mineral acid, 
is borne with ease, and is highly beneficial. 

Regimen. — When the stomach will admit of nourishment, only 
that of the lightest kind should be allowed ; barley-water, and mu- 
cilage of gum Arabic, moderately warm, are the most suitable drinks. 
Every thing of a heating and irritating nature, must be carefully 
avoided for some time after the attack. 



INFLAMMATION OF THE INTESTINES. 247 



INFLAMMATION OF THE 
INTESTINES. 

Symptoms. — Tension of the belly ; obstinate costiveness ; great 
internal pain ; external soreness, especially about the navel, and so 
severe as scarcely to bear the slightest touch ; great debility ; hard, 
small, and quick pulse. 

Causes. — The same, generally, that induce the preceding dis- 
ease. It may also be the sequel of other diseases, as rupture, colic r 
dysentery, worms, &c. 

Treatment. — Whatever may be the cause, we must endeavour 
to bring about, as quick as possible, resolution, lest mortification be 
the consequence. The treatment of inflammation of the stomach 
will also be proper here, as copious bleedings, emollient clysters, fre- 
quently repeated, the warm bath, and immediately afterwards, a 
blister on the belly. — Cupping on the belly is also useful. 

Such is the nature of this complaint, that we cannot be too cau- 
tious in the" administration of medicines or diluents by the mouth. 
But the frequent use of emollient injections will, in great measure, 
supersede their necessity, and at the same time, act as fomentations 
to the parts. Fresh olive oil, in the dose of a table-spoonful, is per- 
haps, the only medicine that can be admitted with safety. When 
the violence of the disease has considerably abated, we may venture 
to give some aperient medicine by the mouth, as castor oil, not rancid, 
calomel, or cathartic mixture. 

In this stage of the disease, laudanum may be employed with great 
advantage, particularly by way of injection. 

When the disease is combined with spasmodic colic, the applica- 
tion of cold to the abdomen, either by means of pounded ice, cloths 
wetted with very cold water, or cold water dashed from a pail imme- 
diately over the belly, has sometimes succeeded, when all other means 
have failed, in removing the obstruction ; producing an increased 
action of the intestines, from sympathy with the external parts. 

Regimen. — After the disease is subdued, the diet should be, for 
some time, of the lightest kind, and not flatulent. — The patient 
must be kept quiet, avoiding cold, severe exercise, and all irritating 
causes. 



248 INFLAMMATION OF THE KIDNEYS. 



INFLAMMATION OF THE 
KIDNEYS. 

Acute pain and heat in the small of the back ; great numbness 
along the thigh, and not unfrequently, a retraction of one of the 
testicles ; retching to vomit ; voiding the urine in small quantities, 
sometimes very pale, and other times, of high red colour, attended 
with febrile affections. The patient generally feels great uneasiness 
when he endeavours to walk or sit upright, and lies with most ease 
on the affected side. 

Causes. — Excessive exertions, external injuries, violent strains, 
exposure to cold when heated, and calculous concretion in the 
kidneys. 

Treatment. — Bleed copiously, keep the bowels open with castor 
oil and emollient clysters, use the warm bath, or foment the part 
with a hot decoction of camomile or bitter herbs, or hot water alone ; 
give mucilaginous and diluting liquors, as flax-seed tea, bajley- water, 
and thin gruel, with the camphorated powders, (see Dispensatory,) 
or small portions of nitre. A decoction of peach leaves, (see Materia 
Medica,) is also beneficial in this complaint. Flannel wetted with 
spirits, and hartshorn, or tincture of Spanish flies, may be applied to 
the small of the back, for the purpose of exciting some degree of in- 
flammation of the external parts. After the inflammation has some- 
what abated, the exhibition of laudanum in its usual quantities, either 
by mouth or clysters, will add considerably to the cure. The disease 
is often removed by a moderate ptyalism. 

If the disease have been treated improperly, or neglected at the 
onset, and a suppuration take place, known by a discharge of matter 
with the urine, use uva ursi, (see Materia Medica,) or balsam co- 
paiva, twice or thrice a-day, for a week or two, and afterwards, take 
bark or steel. 

Regimen. — The diet should consist of the most mucilaginous 
substances, as arrow-root, sago, milk, buttermilk, custards, flax-seed 
tea, barley, or rice-water, &c. In the convalescent state, moderate 
exercise in the open air is of great service. 



INFLAMMATION OP THE BLADDER HEADACHE. 249 

INFLAMMATION OF THE 

BLADDER. 

Symptoms. — Acute pain at the bottom of the belly, which is 
much increased by pressure ; a frequent desire for, and difficulty in 
making water, and frequent efforts to go to stool, attended with 
febrile affections. 

Causes. — Calculous concretions, suppression of urine from ob- 
struction in the urethra, Spanish flies taken internally, or applied to 
the skin, wounds, bruises, &c. 

Treatment. — It must be treated as the preceding disease, except- 
ing that, where there is an entire retention of urine, the jTatient 
should drink no more than absolutely necessary. Gum Arabic kept 
in the mouth will sheath the inflamed parts without adding to the 
quantity of urine. If necessary, the catheter must be introduced, 
though much care is required in the attempt, which often fails. 
After using the warm bath, a cataplasm of mustard and vinegar ap- 
plied to the perinseum or some rubefacient, to excite external inflam- 
mation, will be attended with good effects. 

The lovers of wine and cider should remember that those beve- 
rages, however pleasant and exhilarating, have a tendency to aggra- 
vate all diseases of the kidneys and bladder, especially when they 
originate from an acrid state of the fluids. 



HEADACHE 



If a foul stomach be the cause, give an emetic ; after which, take 
Columbo three times a-day. If from a plethoric habit, which is 
known by a heaviness of the head, and flushed face, bleed and give 
opening medicines. If from rheumatism, apply a blister to the back 
part of the neck, or between the shoulders ; and, at bed-time, bathe 
the feet in warm water, and take the anodyne sudorific draught. 
(See Dispensatory.) If from a weak habit, and where the pain 
returns at stated periods, as in cases of intermittents, and is confined 
to one side of the head, as over an eye, the cure will generally de- 
pend upon the free use of bark and snake-root, or the solution of 
arsenic, twice or thrice a-day ; which seldom fails, especially if pre- 
ceded by a brisk purge. In this, as well as other periodical pains, 
laudanum exhibited in a pretty large dose an hour or two before 
the expected fit, will often prevent its coming on. Edier externallv 
32 



250 HEADACHE. 

applied over the pain on a piece of linen, with a warm hand to con- 
fine it, will afford immediate relief in headaches attended with cold 
skin. Cayenne pepper mixed with snuff, by irritating the mem- 
branes of the nostrils, has also given much relief in cold or nervous 
headaches. 

It is not unfrequent that the partial or nervous headache, as it is 
termed, is produced from a decayed tooth, which, on discovery, 
should instantly be extracted. 

Symptomatic headache is a disease of so many organs, that it is 
difficult to ascertain the organ primarily affected. But when the 
real nature of the complaint is ascertained, the practice to be pur- 
sued, will, of course, be obvious. Where the causes are beyond 
our reach, the disease may be mitigated at least by some of the 
remedies we have pointed out, such as paying attention to the 
state %f the bowels, blistering, and keeping up a determination to 
the surface. 

The sympathy between the head and the stomach has been al- 
ready noticed. It is the subject of such constant experience, that 
to enlarge on it would be superfluous. Headache attends fever of 
almost every kind. Eveiy obstruction in the bowels; eveiy accu- 
mulation of sordes, or indigestible matter in the stomach, produces 
the same disease; every obstruction to the regular evacuation of any 
gland, particularly those of the surface; every nervous affection, 
either from excessive excitability or exhaustion, has a similar con- 
sequence. 

Repelled fluids from the surface produce very constantly a symp- 
tomatic headache. A cause of this kind is the repulsion of acrid 
matter from the surface, by the application of astringent washes to 
cutaneous affections ; by saturine or mercurial applications as cos- 
metics, from which the head generally suffers, though the mischief 
is often more extensive, and apoplexy or epileptic fits the frequent 
consequences. Repelled gout is a still more serious cause. 

We have not mentioned the mental causes, anxiety, fear, suspense, 
and grief; for these seldom produce the complaint until the body, 
or, in general, the stomach, is affected. The headache of students 
is often merely a nervous affection. — Whatever be the action of the 
nervous fibres in intellectual operations, its excess is often a cause of 
pain ; though, in many instances, the headache of students is con- 
nected with obstructions of the bowels, and very often with increased 
determination to the head. The hysteric headache partakes of this 
nervous cause, particularly when the pain feels as if a nail were 
fixed in the brain. Are we then to be surprised at its frequent oc- 
currence? Is it not wonderful that the head is ever free from pain? 

In the nervous headache, which occurs more frequently than is 
generally suspected, I have found no remedy so effectual as genuine 
wine. It may be given during the paroxysm, to persons unaccus- 
tomed to it, from a half pint to a quart, without producing any other 
than the pleasing effect of mitigating the pain. It is also the best 



EARACHE — DEAFNESS. 251 

preventive of all nervous diseases, when used regularly and in mode- 
ration. (See Vine, Materia Medica.) 

When headache is accompanied with coldness of the extremities, 
bathing the feet in warm water, rubbing them with flour of mustard 
or tincture of Cayenne pepper, and keeping up a general circulation 
to the surface by flannel next the skin, will often afford immediate 
relief. And in cases of great determination to the forehead, as indi- 
cated by a flushed face and preternatural heat, the application of 
cloths wrung out of cold vinegar and water to the head and temples 
will be attended with good effects. 

Those subject to this complaint, should bathe their head every 
morning in cold water, avoid full meals, lie with their head high 
in bed; and always keep their feet warm, and the bowels in a 
regular state. 



EARACHE 



Is frequently produced by living insects getting into the ear. The 
most effectual way to destroy them, is to blow in the smoke of to- 
bacco, or pour in warm sweet oil. If occasioned by cold, inject 
warm milk and water in the ear, or drop in a little laudanum or vo- 
latile liniment. If this produce not the desired effect, foment the ear 
with steam of warm water, and apply a bag of camomile flowers, in- 
fused in boiling water, and laid on often, as warm as can be borne. 

When the inflammation cannot be removed, a poultice of bread 
and milk, or roasted onions may be applied to the ear, and frequently 
renewed till the abscess breaks ; after which, it must be syringed 
twice or thrice a-day, with Castile soap and water. In this com- 
plaint, a blister behind the ear is highly useful. 



DEAFNESS 



Is occasioned by any thing injurious to the ear, as loud, noise from 
the firing of cannons, violent colds, inflammation or ulceration of 
the membrane, hard wax, or by a debility or paralysis of the audi- 
tory nerves. It also frequently ensues in consequence of long pro- 
tracted fever. 

Treatment. — It is difficult to remove deafness, but when it is 
owing to a debility of some part of the organ, or arises in cons©- 



252 TOOTHACHE. 

quence of any nervous affection, stimulants dropped into the ear, 
often prove salutary. 

Ether dropped into the ear, seems to possess a twofold effect, one 
of dissolving the indurated wax, and the other of stimulating the 
torpid organ ; but it is liable to excite some degree of pain, unless it 
be freed from the sulphuric acid. No prescription for deafness from 
indurated wax ever acted more surprisingly — none, I am sure, more 
agreeably, to my feelings, at least — than the following : — 

In consequence of a violent attack of bilious fever, which degen- 
erated into the nervous, my honourable friend, Colonel George M. 
Troup, of Georgia, was afflicted with a deafness for a year or two, so 
entire, that, in Congress, when the members were on the floor, he 
was obliged to place himself close to the orator, and even then, fre- 
quently failed of the pleasure and profit of hearing his reasonings. 
Suspecting indurated wax to be the cause of his deafness, I directed 
the cavities of both ears to be well syringed with warm and strong 
suds of Castile soap. This was done twice a-day, the ears con- 
stantly filled in the interim with pellets of wool dipped in strong 
camphorated liniment, and sometimes plugs of camphor. In a few 
weeks, the nerves of hearing recovered their sensibility, and, as the 
Colonel himself thought, more acutely, if possible, than before. 

Salt water is a better menstruum for the wax, and may be em- 
ployed, or some of the table salt finely powdered may be dropped in 
the ear. There is reason, however, for apprehending one bad effect 
from this remedy ; namely : giving such a susceptibility to the organ, 
that it is more liable in future to be affected by cold, and, therefore, 
this remedy must be employed with caution. 

Deafness, in old people, is sometimes attended with noise in the 
.ears, and is then generally owing to debility. Every evacuation 
increases it, and warm tonics, with a generous diet, are the best 
remedies. 



TOOTHACHE 



Is best removed by extracting the tooth ; but if this cannot be 
effected, fill the cavity with a little cotton dipped in the toothache 
drops, Turlington's balsam, or any of the essential oils, or with pills 
of camphor and opium. 

The nerve may sometimes be destroyed by a hot iron or knitting 
needle. A carious tooth is sometimes pained by accidental colds, 
and in such cases, it would not be prudent to have it extracted. If 
the external aperture be smaller than the carious cavity, after clear- 
ing away the carious matter, the access of air may be impeded by 
stuffing of gold or silver leaf. When the nerve is accustomed to the 



TOOTHACHE. 253 

external air, it will continue carious for many years without pain, 
and be truly useful. 

When toothache is connected with rheumatism or gout, which 
sometimes happens, the remedies of either should be employed. 

This unpitied, though often excrutiating pain, is, in most cases, no 
more than the just punishment of our neglect of the teeth. Surely, 
then, we ought to take some care of them, though it were but for 
the pleasure of having them sound. But this care would be re- 
doubled, were we but daily to consider the advantage of good and 
clean teeth and sweet breath. Some women, indeed, are blessed 
with faces so nearly angelic, that not the blackest teeth can entirely 
defeat iaeir charms, nor the vilest breath drive away their lovers. 
But how different would be the effect of both, if, through their ruby 
lips, opened with a smile, we were to see teeth of ivory, white as 
snow, pure as the fair owner's fame, and accompanied with breath 
as sweet as that of infancy. 

The following tooth powder and wash will be found valuable. 
Tooth powder. Of the powder of red bark and armenian bole, of 
each one ounce. Powdered cinnamon half an ounce. Bicarb of 
soda half an ounce. Oil of cinnamon three drops. 

Tooth-wash. — Take of port wine one ounce. Carbonate of 
soda one drachm. Tincture of myrrh one drachm. Oil of horse- 
mint applied with a pellet of cotton or lint to the tooth has proved 
of the greatest benefit in putting an end to the pain of toothache. 

Prevention. — To prevent the toothache, and to preserve the 
teeth and breath perfectly sound and sweet, the tooth-brush dipped in 
warm water, and in the charcoal tooth-powder, (see Dispensatory,) 
should be used constantly every morning. The charcoal powder, 
an invention of the celebrated Darwin, is good for whitening the 
teeth, and admirable in correcting bad breath. The tooth-pick and 
tumbler of pure water should never be forgotten after every meal. 

If the calcarious crust or tartar upon the teeth adhere firmly, a 
fine powder of pumice stone may be used occasionally. When the 
gums are spongy, they should be frequently pricked with a lancet, 
aud gently rubbed with a powder composed of equal parts of Peru- 
vian bark and charcoal. 

Young persons who wish to carry their teeth with them through 
life, must take care never to sip their tea scalding hot, nor drink wa- 
ter freezing cold. Such extremes not only injure the tender coats 
of the stomach, but often ruin the teeth, and have caused many 
imprudent persons to pass a sleepless night, distracted with pains of 
the teeth and jaws. 



254 RHEUMATISM. 



RHEUMATISM 



Symptoms. — Wandering pains in the larger joints, and in the 
course of the muscles connected with them, increased on motion, 
and generally worse towards night. When with fever, it is called 
acute or inflammatory rheumatism ; and, without chronic. 

Causes. — Sudden changes of weather; application of cold to the 
body when over-heated ; wearing of wet clothes. 

Treatment. In the inflammatory rheumatism, large and re- 
peated bleedings are necessary, as indicated by the fulnesf of the 
pulse, especially on the first days, and when there is much pain. 
With this should be combined a free use of diluent drinks, as flax- 
seed or balm tea, barley or rice-water, with a little nitre dissolved in 
each draught, or the antimonial powders, or mixture in small doses, 
to excite slight perspiration, which should be kept up with great 
care, as in this relaxed state of the skin, the disease is liable to recur 
upon the least application of cold. 

In this disease, a very essential discharge is the perspiration ; and 
if this be not produced, every medicine appears injurious. Of the 
diaphoretics, Dover's powder seems best adapted to this complaint ; 
and it should be observed, when sweating is once begun, should not 
be intermitted, and when it has relieved, should be suffered very 
gradually to decline. 

The foxglove, exhibited in doses from ten to twenty drops every 
four hours, will be found a remedy of considerable efficacy, particu- 
larly when an objection is made to the free use of the lancet. The 
blood root, (see Materia Medical) is also a useful auxiliary in this 
disease. 

Bleeding and blistering over the part affected, when the pain and 
inflammation continue violent, have likewise their good effects. 

After the inflammatory symptoms have in a great measure sub- 
sided, the anodyne sudorific draught or bolus, (see Dispensatory,) 
or laudanum alone, may be administered at bed-time, with great 
advantage. 

During this general treatment, attention must be paid to the state 
of the bowels, which should be kept open by emollient clysters or 
cooling medicines, as the cathartic mixture, or castor oil, exhibited 
in small and repeated doses. 

When the disease has fully attained its chronic state, it then forms 
a local affection, distinguished merely by stiffness, distension, and 
considerable immobility in the joint. 

In this species of the disease, a different plan of cure must be fol- 
lowed. Large evacuations are to be avoided, and external stimu- 
lants of the warmest kind should be applied, as the oil of sassafras, 
spirits of turpentine, opodeldoc, or the tincture of red pepper and 
mustard ; and, along with this, friction with a flesh brush or flannel 



RHEUMATISM. 256 

over the afflicted joint is not to be omitted. If these means prove 
ineffectual to rouse the energy of the part, add to an ounce or two 
of either of the above articles, one or two drachms of the tincture of 
Spanish flies. In addition to these remedies, the internal use of the 
rheumatic tincture, (see Dispensatory ,) in doses of a table-spoonful, 
twice or thrice a-day in a cup of tea, is much to be depended upon. 

When these remedies prove ineffectual, we may suspect that some 
peculiar fault exists in the habit, which must be corrected before a 
cure can be expected. If the patient be much debilitated, or of a 
scorbutic habit, give him the nitric acid diluted, or bark freely. And 
if the disease be in consequence of venereal taint, or taking cold from 
the use of mercury, let him take calomel in small doses, or one of 
the mercurial pills night and morning until a ptyalism be produced. 
A strong decoction of sarsaparilla, (see Materia Medica,) is also a 
useful auxiliary, and sometimes a remedy of itself. 

In some cases of obstinate rheumatism, I have witnessed the hap- 
piest effects from taking, for some time, a tea-spoonful of flour of 
sulphur night and morning, in milk or spirits and water. In others, 
again, I found nothing equal to the pokeberry bounce, (see Materia 
Medical in doses of a wine glassful, morning, noon, and night. 

The cuckoo pint, or wake robin, (see Materia Medica,) in the 
form of a conserve, with an equal part of sugar, is often highly 
useful. The seneca root and mezereon in the form of decoction, 
has also been exhibited with most happy effects. Another valuable 
medicine in chronic rheumatism is the spirits of turpentine, in doses 
from twenty to sixty drops three times a-day, which may either be 
given on sugar, in a little water, or incorporated with double the 
quantity of honey, by melting them together over a gentle heat. 
But it should be observed that these active stimulants are never to 
be employed when there is the least febrile action prevailing in the 
system. 

The solution of arsenic has, in some instances, been exhibited 
with success in the chronic form of this complaint. 

Compressing the large arteries by means of a tourniquet or band- 
age, as mentioned under the head of intermittents, is another remedy 
which has been employed with advantage in severe rheumatic pains. 

In recent cases, when the pain wanders from one part to the other, 
or whenever the joints are stiffened and rigid, and the pain upon 
motion severe, or where the muscles have become contracted, by the 
length and violence of the disorder, immersing the whole body in a 
warm bath, strongly impregnated with salt, or applying it topically, 
by pouring warm water upon the limb from a kettle, or fomenting 
the part with a decoction of mullein two or three times a-day, will 
often sooth the pain, and prove a useful auxiliary to the other means 
we employ. 

Warm bathing, and warm pumping, are remedies of great utility 
in this disease; but as it requires painful muscular exertion to use 
the warm bath, it is not often resorted to. The vapour bath, from 
its superior temperature, is better adapted to its chronic form. 



256 TIC DOULOUREUX. 

Two other forms of rheumatism ought here to be mentioned; 
namely, the lumbago, and the sciatic. The first attacks the loins or 
lumbar region, with a most acute pain shooting to the joints of the 
thigh. This affection is nearly related to the inflammatory rheu- 
matism, and must be treated in the same manner ; only, instead of 
applying blisters over the affected part, they should be applied on 
the inside of the thighs, and kept running for some time. 

The second, or sciatic, a violent, or fixed pain, attacking the hip 
joint, and partaking of the nature of the chronic rheumatism, is most 
successfully to be treated like that disease. 

Regimen. — In acute rheumatism, the patient must be kept on a 
cool spare diet; but no change whatever will be necessary in the 
patient's ordinary mode of living, in chronic rheumatism-. In this 
species, mustard and horse-radish, (see Materia Medica,) used freely 
in their natural state, or united with food, will be found very bene- 
ficial. In all cases of both diseases, flannel, or fleecy hosiery, should 
be worn next to the skin, a flesh brush be used morning and night, 
and every precaution be taken to guard against exposure to cold and 
wet, and also to a moist or damp atmosphere. If the appetite be im- 
paired, stomachic bitters, elixir vitriol or some of the tonic medicines 
may be taken with advantage. Exercise, either of the whole body 
or of particular limbs, will be highly important. The want of exer- 
cise is apt to produce stiffness in the limbs. 

Prevention. — Cold bathing, and the use of flannel next to the 
skin, are the most effectual means of preventing the recurrence of 
both acute and chronic rheumatism. 



TIC DOULOUREUX, 

OR PAINFUL AFFECTION OF THE FACE. 

Symptoms. — A painful affection of the nerves, which mostly at- 
tacks the face. The most frequent seat of the affection is in the 
nerves over the cheek bone, just below the orbit of the eye, the nos- 
trils, upper lip, and gums. The pain is often excited by opening 
and moving the mouth, attended with ptyalism and convulsive agi- 
tation of the adjacent muscles. The only diseases likely to be con- 
founded with this are, rheumatism occupying the face and jaws, and 
the toothache. It may, however, readily be distinguished from the 
former of them, by an attack of pain being readily excited, by the 
slightest touch, by the shortness of its continuance, and by its ex- 
treme severity and violence ; and from the latter, by the rapidity 
of its succession, and there being an entire freedom from pain at 
intervals. 



TIC DOULOUREUX. 257 

Treatment. — A very great variety of medicines, given inter- 
nally, as well as remedies applied externally, have been tried for 
the alleviation and removal of this excruciating complaint, and even 
a division of the nerve has been resorted to ; but although this ope- 
ration has answered the purpose in a few cases, still it has failed in 
many others. 

Electricity, blisters, topical bleeding, by means of leeches, stimulant 
and anodyne embrocations, and frictions with mercurial ointment, 
have all been employed in rotation as external applications ; whilst 
the solution of arsenic, large doses of the extract, as also powder of 
Peruvian bark, preparations of iron, opium, and the extracts of hen- 
bane, hemlock, and nightshade, have been administered internally 
in considerable doses. 

It appears that the nightshade (bella donna) has, in many cases, 
proved a powerful and very efficacious medicine, and may, therefore, 
be given with confidence. From two to three grains of the extracts 
have been administered every five or six hours to adults during the 
great severity of the pain, or from twenty to forty drops of the tinc- 
ture, lessening the dose very considerably as soon as ease was pro- 
cured. It will always be most advisable to begin the use of this 
medicine in small doses, such as half a grain of the extract for an 
adult, repeated every four or six hours, increasing the quantity, by 
degrees, to about two grains ; and we may, at the same time, make 
trial of it as an outward application to the cheek, by laying over it a 
piece of fine linen rag, moistened in a solution of the extract in water, 
in the proportion of six grains of the former, to two ounces of the 
latter, or it may be wetted in the tincture of nightshade. The use 
of this medicine internally, is, however, often attended with distress- 
ing symptoms, when given in such doses as to produce a certain 
effect, as impaired vision, giddiness in the head, numbness, tightness 
at the chest, and a sense of suffocation, with dryness in the throat ; 
but these soon cease again, on greatly diminishing the dose, or wholly 
discontinuing the remedy. 

As persons unaccustomed to the use of so active a medicine, might 
be intimidated even by the probability of such unpleasant conse- 
quences, we would recommend them to make a previous trial of the 
carbonate of iron, in doses of one scruple, repeated three times a-day, 
gradually increasing each dose to the extent of one drachm, if no 
decided benefit be derived by taking it in smaller quantities. This 
remedy has been employed in several cases of the tic douloureux 
after a failure of very large doses of the extract of bark, the solution 
of arsenic, and most of the other means usually resorted to, with an 
exception of nightshade, in all of which the complaint soon ceased. 
and has not again returned in any of them. 

In the treatment of this very painful complaint, it has been advised 

to paralyze the nerve by the application of an ointment, consisting 

of two scruples of the superacetate of lead (sugar of lead") mixed 

with a little lard, every morning on the cheek affected about an 

33 



258 VACCINE DISEASE, OR COW-POX. 

hour before the paroxysm is expected. The experiment has been 
tried with success by Mr. Astley Cooper, in a case which had pre- 
viously resisted every other remedy, and even a division of the nerve 
by the knife. 

The following application has proved of signal benefit in this dis- 
tressing disorder. Laurel- water four ounces. Sulphuric ether one 
ounce. Extract of bella donna half a drachm to a drachm. To be 
applied to the part with cotton wadding wetted with it. 

A useful application will be found in the following ointment. 
Extract of bella donna half an ounce. Pulverized opium two scru- 
ples. Hog's lard half an ounce. Oil of thyme six drops. To be 
used with friction. 

Pills of bella donna and quinine have been very beneficial in a 
very distressing and protracted case in which many of the usual 
remedies had failed. Morphia has been applied by the skin to cure 
this complaint in the following manner. Two or three centigrammes 
of the sulphate of morphia were dissolved in a small quantity of 
water on a bit of glass. This solution was taken upon a vaccinating 
lancet, and forty punctures over the seat of pain were made. The 
operation was repeated several times and the patient completely 
cured. 

This disease has been successfully treated with tobacco. Take 
of the best shag tobacco four ounces. Distilled water two pints. 
Boil and let them simmer for two or three hours, and strain ; then 
wash the tobacco in two pints more of boiling distilled water ; strain 
and add it to the former liquor, and evaporate to an extract. One 
part of this extract to be mixed with seven parts of simple cerate to 
form an ointment. To make it more elegant, add a little neroly. 
Half a drachm night and morning to be rubbed in the part suffering. 
This has also cured toothache, used in the same manner by friction. 
It has been affirmed by some with great plausibility that this com- 
plaint arises from pressure produced by congestion of the blood ves- 
sels accompanying the nerve in its adit and exit from its bony canal. 
In this case, the application of cold would be of service, and such 
remedies as are likely to lessen such a state of aggravation. 



VACCINE DISEASE, 

OR COW-POX. 

The vaccine discovery may be justly considered as one of the 
most extraordinary blessings entailed on man ; since it is incontesta- 
bly a certain security against the small -pox, a disease distressing in its 
symptoms, formidable in its appearance, doubtful in event, and to 
which mankind are generally exposed. 



■MBHM 



VACCINE DISEASE, OR COW-POX. 259 

The comparative advantages which the kine-pox has over the 
small-pox, are very great and striking. First, it is neither conta- 
gious nor communicable by effluvia; secondly, it excites no disposi- 
tion to other complaints ; thirdly, it can be communicated, with 
safety, to children at the earliest age, and almost in every situation ; 
and fourthly ', it is never fatal. What more can be required to pro- 
duce a general conviction of its superior utility? The method of 
performing the inoculation is, to hold the lancet nearly at a right 
angle with the skin, in order that the infectious fluids may gravitate 
to the point of the instrument, which should be made to scratch the 
skin repeatedly, until it becomes slightly tinged with blood. The 
operator must be cautious not to make the wound deeper than ne- 
cessary, as the inoculated part will be more liable to inflammation, 
which may destroy the specific action of the virus. 

The most certain method of securing the infection is, to inoculate 
with fresh fluid from the pustule ; but as this is often impracticable, 
it is advisable to hold the infected lancet over the steam of boiling 
water to soften the hardened matter. Where the virus has been 
procured upon thread, make a small longitudinal incision in the arm, 
and insert in it the affected thread, and detain it there by court- 
plaster, until the disease be communicated. Matter may also be 
procured from the scab. The mode of inoculating from it is the 
same as from the fluid, taking care, however, previously to moisten 
it with tepid water, and to use the matter of the inner side of the 
scab. The scab will frequently retain its virus for months, provided 
it be kept in a close box. 

The first indication of the success of the operation is a small in- 
flamed spot where the puncture has been made, which is very dis- 
tinguishable about the third, fourth, or fifth day. This continues to 
increase in size, becomes hard, and a small circular tumour is 
formed, rising a little above the level of the skin. About the sixth 
or seventh day, the centre of the tumour shows a discoloured speck, 
owing to the formation of a small quantity of fluid, which continues 
to increase, and the pustule to fill, until about the tenth day. 

At this time it shows nrperfection the characteristic features which 
distinguish it from the variolous pustule. Its shape is circular, or 
somewhat oval, but the margin is always well defined, and never 
rough and jagged. The edges rise above the level of the skin, but 
the centre is depressed, and has not that plumpness which marks the 
small-pox pustule. As soon as the pustule contains any fluid, it may 
be opened for future inoculation. About two days before, and two 
after the eighth day, making a period of four days, is the season 
when the matter is found in its greatest activity. 

At the eighth day, when the pustule is fully formed, the efTects on 
the constitution begin to appear. The general indisposition is com- 
monly preceded by pain at the pustule and in the armpit, followed 
by headache, some shivering, loss of appetite, pain in the limbs, and 
a feverish increase of pulse. These continue with more or less vio- 



260 VACCIXE 



OR COW-POX. 



lence for one or two days, and always subside spontaneously without 
leaving any unpleasant consequences. During the general indispo- 
sition, the pustule in the arm, which had been advancing to matu- 
rity in a regular, uniform manner, becomes surrounded with a cir- 
cular inflamed margin, about an inch or an inch and a half broad, 
and this blush is an indication that the whole system is affected ; 
for the general indisposition, if it occur at all, always appears on or 
before the time when the effloresence becomes visible. After this 
period, the fluid in the pustule gradually dries up, the surrounding 
blush becomes fainter, and in a day or two imperceptibly dies away, 
so that it is seldom to be distinguished after the thirteenth day from 
inoculation. The pustule now no longer increases in extent, but on 
its surface a hard thick scab, of a brown or mahogany colour is 
formed, which, if not removed, remains for nearly a fortnight, until 
it spontaneously falls, leaving the skin beneath perfectly sound and 
uninjured. 

The above is the progress of the vaccine inoculation in the greater 
number of cases, from the time of insertion to that of drying up of 
the pustule, with only the variation of a day or two in the periods of 
the different changes. The successive alterations, that take place in 
the local affection, appear to be more constant and more necessary to 
the success of the inoculation, than the general indisposition. With 
respect to the latter, the degree is very various : infants often pass 
through the disease without any perceptible illness ; with children it 
is extremely moderate ; and even with adults, its severity is but for 
a few hours, and then never dangerous. 

Very little medical care is necessary to conduct the patient through 
this disease with safety, especially when children are the patients. 
Adults may take a dose of salts on the eighth day, which will be 
particularly useful in plethoric habits. In general, no application to 
the inoculated part will be required, unless tbe inflammation in- 
crease, and the pustule become painful ; then the part should be kept 
moist with cold vinegar and water, or lead-water, till the pustule be 
dried up. 

To conclude, much attention and discrimination are necessary in 
the vaccine inoculation, to ascertain whether the infection have folly 
taken, and whether or not the disorder be complete and genuine. 
The regularity, with which the local disease at the place of inocula- 
tion runs through its several stages, seems to be the principal point 
to be attended to : for the presence of fever is certainly not necessary 
to constitute the disease, since the greater number of infants have 
no apparent indisposition. 

Therefore, when the vaccine inoculation is followed by no local 
disorder, or only a slight redness at the punctured part, for a day or 
or two, we can have no doubt that the operation has failed. When 
the pustule advances in veiy hasty and irregular progress, when the 
inoculated puncture, on the second or thud day after insertion, swells 
considerably, and is surrounded with an extensive redness, the pre- 



SMALL-POX. 261 

mature inflammation very clearly indicates a failure in the operation, 
even when the inoculation has advanced for the first few days in a 
regular manner ; but when, about the sixth day, instead of exhibit- 
ing a well formed pustule and vesicle of fluid, the part runs into an 
irregular festering sore, the purpose of inoculation is equally defeated, 
and these varieties require it to be watched with an attentive and 
experienced eye ; since they might readily lead to a false, and per- 
haps fatal idea of security against any subsequent exposure to small- 
pox. The circumstance, however, which most strikingly distin- 
guishes the genuine from the spurious disease, is the appearance of 
the pustule. In the genuine, the pustule has a well-defined elevated 
margin, with an indentation in its centre, resembling a button mould. 
The spurious is either pointed like a small common abscess, or is 
rugged and irregularly formed, like an ordinary sore. Every other 
symptom, almost, occurs in each disease. 



SMA LL-POX 



It would seem unnecessar)^ to take any notice of the small-pox, 
after having treated so largely of its mild and merciful substitute, the 
cow-pox ; but as that dreadful disease does sometimes find its way 
on board of ships and into country neighbourhoods, sweeping whole 
families in its progress, it may be very proper to subjoin the follow- 
ing history of its symptoms and treatment. 

Symptoms. — A few days prior to the attack, the patient complains 
of languor and weariness, succeeded by cold shiverings and transient 
glows of heat, immediately before the fever, which is accompanied 
by violent pain of the head and loins, and, frequently, with a se- 
vere, oppressive pain at the pit of the stomach. The patient is 
very drowsy, and sometimes delirious. About the third day, the 
eruption appears like flea-bites, first on the face and limbs, and after- 
wards on the body. From this perid, the pustules gradnally in- 
crease, and on the fifth or sixth day, will begin to turn white on the 
tops. The throat, at this period, often becomes painful and in- 
flamed ; and sometimes on the seventh day, the face is considerably 
swelled. 

In the confluent, the spots assume a crimson colour, and instead 
of rising, like the distinct kind, they remain flat and run into clus- 
ters ; and, during the first days of the eruption, much resemble the 
measles, but are of a purple colour. The flow of saliva is constant 
in this form of the disease, and becomes so viscid as to be discharged 
with the greatest difficulty. 

Treatment. — The cure of small-pox depends on the general 
principle of the antiphlogistic plan, especially in a free admission of 



262 SMALL-POX. 

cold air, which maybe carried much farther in this than in any other 
disease. Bleeding in the first stage of this disease, or when the 
pulse is full, may be allowed ; but the use of cooling purgatives, with 
acid and diluent drinks, are indispensable. 

When the eruption makes its appearance in clusters of a dark red^ 
colour, the disease is more of a putrid nature; and, consequently, in- 
stead of bleeding, requires a liberal use of bark and wine to invigo- 
rate the constitution, as directed in the nervous fever. (See Oak, 
Materia Medica.) 

But, besides this general treatment, there are some symptoms 
which require particular attention. Thus, when convulsions or 
great restlessness prevails, exposure to cold air, and a dose of lauda- 
num are enjoined. Where perspiration is much impeded, or deglu- 
tition difficult, blisters may be applied to the breast and neck ; and 
gargles, such as recommended for sore throats, frequently employed. 
If the perspiration be obstructed, the antimonial mixture may be 
used. 

When this disease finds its way aboard of a vessel, or into a family, 
all those who have not had it, should immediately be inoculated 
with the variolous matter, if the vaccine fluid cannot be procured. 

The benefits which result from inoculation are great, as we have 
an opportunity to prepare the system by abstinence from animal 
food, and by taking one or two purges of calomel and jalap before 
the eruption takes place. But if the subject be of a weak delicate 
habit, a restorative diet alone will be more proper. 

In every stage of the small-pox, the bowels should be kept open, 
either by mild purgatives or clysters. 

The following remarks of a writer in Queen Mary's time respect- 
ing the conduct or management of this disease have so much truth 
in them, I cannot refrain from giving them a place here. " Take 
away the blood in which the vital potency resides, and you mani- 
festly weaken the sick more and more, and diminish the spirits which 
ought to oppose, or encounter the disease. For nature, through 
bleeding, being weakened (not only by being robbed of her defence, 
but by introducing an enemy, who universally defiles her economy 
and quenches the vital flame) there immediately an universal weak- 
ness spreads over the whole human frame, and the contest of nature 
with the disease ceases, by nature's being overcome. This truth is 
so evident, that we cannot but speak it with grief, when we do but 
think of that late precious life, which by that means, we faithfully 
believe, was lost. In a thousand that have this disease and are let 
blood, at least, nine hundred and fifty of them die, and of this mine 
own eyes are witnesses. Whenever any of the blood-sucker's pa- 
tients die, the pustules seem to fall in again, grow flat and dead, or 
to dent in the middle; and sometimes to turn purple, livid, or black; 
with many livid or purple spots in the interspaces. Then to excuse 
themselves, they say it was a dangerous and malign disease, and 
complicated with an erysipelas, purples, spotted fever, or the like ; 



SMALL-POX. 263 

by reason of which complication, 'twas impossible for the sick to 
escape death, what course soever had been taken." 

The best treatment consists in good nursing and a plenty of fresh 
air. 

HISTORY OF THE SMALL-POX. 

At what period of the world this scourge of mankind appeared, 
has never been determined. The ancient Greeks and Romans gave 
no evidence that they had a knowledge of it. The Arabian physi- 
cians were the first to give an account of it. Rhazes, an Arabian 
physician, described it about the beginning of the tenth century. It 
is supposed to have been conveyed about the middle of the sixth 
century by trading vessels from India to Arabia. And there is no 
question that the triumph of the Arabian or Saracenic arms, intro- 
duced it from Africa into the Levant, Spain and Italy. 

It spread its desolating ravages with great rapidity, during the 11th 
and 12th centuries, while Christian potentates arrayed their countless 
hosts in quest of the Holy Land. 

OF INOCULATION. 

This method of protection is derived from China, where it has 
been practised from time immemorial. From China it travelled into 
India and thence into Asia Minor — thence into Africa. They make 
(it is said) the incision when they inoculate, between the eye-brows. 
In 1721, Lady Mary Montague who had witnessed its triumphs in 
Turkey, and who had had a son inoculated there, submitted an in- 
fant daughter to the same process at this time, in London. The 
public and the profession viewed it with suspicion. An experiment 
was ordered to be made on six condemned criminals, all of whom 
were fortunate enough to recover, and who thus redeemed their lives. 
Yet such was the opposition to this innovation, that during a period 
of five years, not more than seven hundred and sixty four persons 
were inoculated all over England. 

OF VACCINATION. 

About fifty years ago it was known among those who kept dairies 
in Derbyshire and other counties in England, that cows are subject 
to a pustular disease, which, when communicated to milkers rendered 
them insusceptible of small-pox infection. Attempts were made to 
convey the small-pox to those who had been infected with the cow- 
pox, but all such attempts were fruitless. To Dr. Jenner is due the 
credit of taking up this subject and pursuing it with great ardour and 
judgment. He made many experiments, and ventured at length to 
publish his discovery in 1798, and to recommend inoculation with 
the virus of cow-pox as a substitute for smajl-pox. The result is 
well known, and vaccine inoculation has passed with rapid progress 
over every quarter of the world from the Arctic Circles to the" ex- 
tremes of Asia and Africa. 



264 MEASLES. 

Regimen. — The diet is to consist of vegetable substances; as 
arrow-root, panado, milk, rice, &c, and when the eruption is com- 
pleted, a more nourishing diet may be allowed. If the disease be 
of a putrid kind, wine, cider, perry, porter, or milk toddy, may be 
given freely. 

In this, as in all diseases connected with putrescency, the advan- 
tages arising from cleanliness, as well as from frequent ventilation 
of the chambers, are so obvious, that to insist on them is unnecessary. 
(See Nervous Fever.) 



MEASLES. 



This disease is the effect of a specific contagion, and attacks pet- 
sons only once in life. 

Symptoms. — Alternate heat and chills, with the usual symptoms 
of cold. On the fourth day from the attack, eruptions like flea bites 
arise on the face aud body, and in about four days more, these erup- 
tions disappear with the fever. 

Treatment. — When the disease is very slight, little more is 
necessary than to keep the patient's body open with the cathartic 
mixture. But, should the febrile symptoms run high, with difficulty 
of breathing, bleed, blister the breast, and give Dover's or antimonial 
powders, the febrifuge mixture, or diaphoretic drops. (See Dispen- 
satory.) The cough being usually troublesome, it will be proper 
to take freely of flax-seed syrup, or some of the pectoral mixtures. 
Breathing the steams of warm water will also be useful, in relieving 
the cough as well as the eyes. The water should be put in a basin, 
and the head covered with a flannel large enough to hang over its 
edges. After the eruption is completed, the anodyne sudorific 
draught, paregoric, or laudanum, will be serviceable at bed- time, to 
allay the cough. If the spots suddenly disappear, immerse in warm 
water, or bathe the legs and feet, and give freely of warm wine whey, 
until the eruptions return. 

The consequences attendant on the measles, are often more to be 
dreaded than the immediate disease ; for although a person may get 
through it and appear for a time recovered, still pulmonary consump- 
tion frequently arises and destroys him. Another bad consequence 
of the measles is, that the bowels are often reduced to a very weak 
state, a diarrhoea remaining, which has sometimes proved fatal. An 
obstinate ophthalmia, or affection of the eyes, will also ensue, if pro- 
per attention be not paid in managing the disease. Most of these 
disagreeable symptoms may be prevented by blood-letting, and ad- 
ministering emetics, cathartics and diaphoretics, in the first stage of 
the disease. 



CHICKEN, OR SWINE-POX — MILIARY FEVER. 265 

Should the symptoms manifest a malignant kind of the disease, 
and a putrid tendency prevail, we must then adopt a very different 
mode of treatment from what has been advised for the inflammatory. 
The cure must be conducted on the plan recommended for the ner-. 
ous fever, and putrid sore throat. 

Regimen. — The diet should be low and proportioned to the degree 
of fever. Barley or rice-water, flax-seed tea, or other cooling mu- 
cilaginous drinks, with jellies, as arrow-root, gruel, sago, &c, will, 
in general, be all that is necessary, until the feverish symptoms be 
evidently on the decline. Much caution is necessary, that the patient 
be not suddenly exposed to cold air, which might repel the eruption, 
and produce fatal effects. 



CHICKEN, OR SWINE-POX. 

In this disease, an eruption much resembling that of a very fa- 
vourable small-pox, appears after a very slight fever. This eruption 
soon proceeds to suppuration, in which state it remains but a little 
time, before the disease terminates by the drying up of the pustules, 
which seldom leave scars behind. 

As to the treatment, medicine is very seldom necessary, it being 
generally sufficient that the patient be kept moderately cool, and 
supplied with the diluent drinks and light food. — Should there be 
fever, a cooling purge, and afterwards, the antimonial powders, or 
mixtures, may be employed. 



MILIARY FEVER 

Is now considered to be symptomatic, only, because it never ap- 
pears contagious or epidemic. It sometimes attends febrile affections, 
as well those of an inflammatory as of a putrid nature ; but it sel- 
dom occurs in any, unless a hot regimen and sweat precede. The 
symptoms which attend, are restlessness, frequent sighing, fetid 
sweat, pricking of the skin, and an eruption of red small distinct 
spots, at first confined to the neck, breast, and arms, but soon spreads 
over the whole skin, except the face. When these eruptions make 
their appearance, they must be treated according to the rules laid 
down under their proper heads. 
34 



266 SCARLET FEVER. 



SCARLET FEVER. 

Symptoms. — Chilliness, followed by a burning dry heat; the 
pulse frequent, respiration irregular, a dejection of spirits, great pros- 
tration of strength, and often a stiffness of the neck. The face and 
neck are at first covered with red spots, which soon extend over the 
whole body. A sore throat generally comes on about the second or 
third day, but sometimes is wholly absent ; however, a redness of 
the fauces in every case is conspicuous. This fever is distinguished 
from the measles by the eruption being less distinct and more like a 
red-coloured effusion, and by not being accompanied by catarrhal 
symptoms. It is distinguished from Saint Anthony's fire by the 
fever being more considerable at night than the former, and the 
swelling being scarcely observable. It attacks more frequently 
young children ; whereas, Saint Anthony's fire is mostly confined to 
adults, and is not attended with a scarlet hue on the throat. This 
fever is evidently infectious, generally epidemic, and appears most 
frequently at the end of summer. 

Treatment. — Give an emetic on its attack, and on the following 
day administer some gentle cathartic medicine. The bowels should 
be kept in a soluble state, and nitre given in the patient's drink. 
The heat should be repelled rather than encouraged. And this is 
to be effected by cold affusions, which should be steadily applied. 
It is not enough to sponge the body once or again, but the cold 
water must be dashed against the patient repeatedly till the heat 
is subdued, and the process must be repeated as fast as it returns. 
In this disease, cold water is peculiarly applicable ; the heat being 
considerable, the determination to the head violent, and the debility 
alarming. 

We know no disorder which represses so powerfully the constitu- 
tional energy. Q,uinine and cordials would appear peculiarly useful 
in this complaint, from its tendency to putrefaction ; but if these be 
early employed, they will be found to increase both fever and de- 
lirium, to check the perspiration, and to impede sleep. 

Where this disease is attended with malignant symptoms, its ten- 
dency is to the putrid kind of fever, and must be treated accordingly. 
(See Nervous Fever, and Putrid Sore Throat.) 

Regtmen. — The diet should be light, the liquors cold, and acidu- 
lated with vegetable and mineral acids. The stools should be fre- 
quently removed, the linen frequently changed, and the room kept 
airy. The nurses should carefully wash themselves, and frequently 
change their linen. With these precautions, there is little danger 
of infection. 



st Anthony's fire — bleeding at the nose. 267 



ST. ANTHONY'S FIRE. 

Symptoms. — An inflammation on some part of the skin, attended 
with pain and heat ; and when extensive, there is considerable fever, 
accompanied with drowsiness. 

Causes. — Imprudent exposure to cold when the body is heated ; 
hard drinking, and sudden stoppage of any natural evacuations. 

Treatment. — When slight, it requires only that the bowels be 
kept gently open, by an infusion of peach leaves, (see Materia 
Medica,) small doses of cream of tartar and sulphur, or the cathartic 
mixture, with small portions of nitre in the patient's common drink ; 
but when the attack is violent, and the head affected, then, in addi- 
tion to the above, bleed, bathe the feet in warm water, apply a 
large blister between the shoulders, sinapisms to the extremities, and 
give the saline or antimonial mixture, (see Dispensatory ,) with dilu- 
ent drinks. 

The best external applications are flour or starch, gently sprinkled 
by a puff on the part, or, in case of dryness and much heat, fresh 
leaves of the thorn apple, or cabbage leaves stripped of their stems 
and softened in boiling water, and renewed every two or three hours. 
Cold applications, as cloths wetted with vinegar and water, with the 
addition of a small quantity of camphorated spirits, have also been 
employed with great benefit and relief to the feelings of the patient. 

If, in spite of these means, ulceration should take place, apply 
bark poultices, frequently renewed, or cloths dipped in the cam- 
phorated spirits, with the usual means of preventing mortification. 
Should the inflammation assume a purple colour, or the swelling 
suddenly subside, attended with internal oppression, anxiety, and 
pulse, apply blisters or sinapisms to the extremities, and give wine 
or warm toddy freely, to throw out the eruptions to the skin; and 
then it is to be treated as the nervous fever. 

Regimen. — The diet should be low, and the drink chiefly of rice 
and barley-water, acidulated with tamarinds or the juice of lemons. 

Prevention. — Avoid the extremes of heat or cold, abstain from 
spirituous liquors, and keep the bowels regularly open. 



BLEEDING AT THE NOSE. 

In febrile diseases, accompanied with pain in the head, flushed 
countenance, and redness of the eyes, bleeding from the nose in 
general is salutary, and ought not to be checked, unless the patient 
is likely to be too much exhausted by it. — However, when this dis- 



268 



SPITTING OP BLOOD. 



charge is too profuse, the patient should have his head raised and 
exposed to the cool air. Beside which, cold acidulated drinks should 
be used, and the patient should rather immerse his head in very cold 
water, or have cloths dipped in cold vinegar and water frequently 
applied to the nostrils, face and back of the neck. A piece of metal, 
as a key for example, applied cold to the naked back, is a familiar 
remedy, and often succeeds. If these should not prove sufficient, a 
pledget of lint dipt in strong alum-water, or a powder composed of 
flour and alum of equal quantity, should be introduced into the 
nostrils, with sufficient force to compress the orifice of the ruptured 
vessels. In addition to these means, give a dose of Epsom or Glau- 
ber salts, to evacuate the bowels, and from ten to twenty grains of 
nitre every hour or two, in a glass of cold water. Immersing the 
feet in warm water while the cold applications are continued to the 
head, will also be found beneficial. 

One of the most powerful styptics which we can use, says Dr. 
Thomas, is powder of charcoal. It may be applied by means of 
tents, first moistened with water, and then dipped in this powder ; 
but in slight cases, it will answer by being taken like snuff. 

After the bleeding has ceased, the patient must be careful not to 
remove the tents of clotted blood, but should allow them to come 
away of themselves. 



SPITTING OF BLOOD. 

When there is a discharge from the mouth, of blood of a florid 
colour, brought up with more or less coughing, preceded by a sense 
of tightness, weight, and anxiety in the chest, and attended with a 
saltish taste of the spittle, it is in consequence of a ruptured vessel 
of the lungs. 

Causes. — Plethora; violent exercise of the lungs; and, frequently, 
mal-formation of the chest. 

Treatment. — The most important remedy in this alarming 
complaint, is blood-letting, which should be actively employed, 
paying, at the same time, attention to the state of the bowels. Spit- 
ting of blood, however, is sometimes owing to the contraction of 
the chest with debility ; and in this case, the lancet must not be so 
freely used. 

Sedatives, particularly those which repress the activity of the 
circulation, are highly useful. Of these, the chief are nitre and 
foxglove. Nitre, in doses of ten grains, given every hour, in the 
coldest water, and swallowed while dissolving, is much to be de- 
pended on in the early stage of this disorder. — The tincture of fox- 






CONSUMPTION. 269 

glove exhibited in small doses every hour or two, by retarding the 
action of the pulse, will also prove a most useful auxiliary in 
suppressing pulmonic hemorrhages, particularly in those cases where 
an inflammatory diathesis prevails. Whenever there is fixed pain 
in the chest, a blister applied to the breast or back will do much 
service. 

According to Dr. Rush, two tea-spoonsful of common salt, dis- 
solved in a small quantity of water, and exhibited every two hours, 
or oftener, will check this disease, as well as hemorrhages from the 
stomach and uterus. 

Astringents are frequently resorted to, as alum, kino, and sugar of 
lead; but they are of little utility, except in the passive hsemoptyses, 
and even in these, nitre is often found preferable. 

If the cough be troublesome, it will be necessary to have recourse 
to demulcents and pectorals, as advised under the head of cold. 
Sometimes a spitting of blood is produced in consequence of sup- 
pressed evacuation; in this case, it is not dangerous, and only requires 
remedies to restore the customary discharge. 

A spitting of blood may readily be distinguished from a discharge 
of it from the stomach, as, in the latter, the quantity is usually more 
considerable, of a darker colour, and is generally unattended by 
coughing. 

Regimen. — A low diet should be strictly observed, and the body 
kept as quiet as possible. Nothing should be taken warm ; flax- 
seed tea, barley or rice-water, acidulated with the juice of lemons or 
elixir vitriol, ought to be used as common drinks, and taken as cold 
as possible. 

Prevention. — Carefully avoid all exertions which either detain 
or hurry the blood in its passage through the lungs, as singing, loud 
speaking, running, or lifting great weights. Obviate costiveness, by 
the occasional use of mild aperients, and use a spare diet. On ex- 
periencing any pain in the chest, blister, bleed, and constantly wear 
flannel next to the skin. 

Swinging, sailing, travelling in an easy carriage, and riding on 
horseback, will be the most appropriate exercise. 



CONSUMPTION. 



Symptoms. — Those which mark its first stage, are a slight fever, 
increased by the least exercise; a burning and dryness in the palms 
of the hands, more especially towards evening; rheumy eyes, upon 
waking from sleep ; increase of urine ; dryness of the skin, as also 
of the feet in the morning; occasional flushing in one and sometime* 



270 CONSUMPTION. 

both cheeks; hoarseness; slight or acute pain in the breast; fixed, 
pain in one side, or shooting pains in both sides; headache; occa- 
sional sick and fainty fits ; a deficieney of appetite ; and a general 
indisposition to exercise, or motion of every kind. 

The first appearance of this disease will vary in different cases ; 
but the most constant symptoms which characterize it, are a cough 
and phlegm resembling matter, of which, at length, it becomes en- 
tirely composed. 

This disease often attacks insidiously, and is chiefly confined to 
the young, the fair, with light skin and blue eyes, florid complexions, 
contracted chest, and high shoulders. In constitutions disposed to 
hectic, the fingers are often long, and the nails bent ; they grow 
rapidly, but seldom expand in breadth and bulk. From the age of 
twelve or fourteen, to that of about thirty-five, is the hectic period ; 
more generally from sixteen to twenty-four; and the tendency seems 
to return about forty-five or fifty, especially in women at the period 
of the cessation of the catamenia. At the age of fourteen or sixteen 
in each sex, while the genital organs are evolving, there is often a 
considerable debility and irritability. The debility in females is often 
formidable, and a slight cough is no uncommon attendant. The 
cough is either quite dry, or accompanied with an expectoration of 
a small quantity of a thin frothy matter, which differs from that of 
true catarrh, in being easily diffusable in other fluids. Sooner or 
later, the general health becomes impaired, and at length, the fatal 
hectic makes its appearance with little suspicion ; all the symptoms 
being referred to the great change that then takes place. No diagno- 
sis can arise from the existence of fever, since in the chlorotic state 
coldness, with occasional flushing, are not unfrequent. In general, 
however, the fever of phthisis attacks more pointedly in the evening; 
that of chlorosis in the morning. The appetite of hectic patients is 
best in the forenoon ; of chlorotic at night ; and the latter can eat 
meat suppers frequently with impunity. 

It sometimes occurs that persons who have been improperly treated 
in the venereal disease, have symptoms which assume the form of 
consumption ; but, in general, the chest is free, while pains are more 
violent at night, and more frequently in the middle of the bones of 
either extremity, or deep-seated in the head, than in the trunk. It 
has also seldom proceeded so far as to mislead, without showing its 
nature by eruptions, or by an affection of the throat. From the state 
of mind, we may draw some distinction ; for cheerful hope illumines 
eveiy hour of the hectic; despair darkens each moment of the 
syphilitic patient. 

Strange as it may appear, amidst all the horrors of this disease, 
the patient's hopes are seldom abandoned, and even increase, as the 
fatal termination advances. 

Causes. — Obstructions and inflammation of the lungs, depending 
most frequently on the existence of small tubercles in the substance, 
which, coming to suppuration, burst and discharge a purulent mat- 



CONSUMPTION. 271 

ter. Sometimes, it is induced by a general affection of the system, 
and sometimes it is a consequence of other diseases, as cold, measles, 
small-pox, pleurisy, &c. &c. 

Treatment. — This must be varied and adapted to each stage 
and case of the disease. In the first or inflammatory stage, moderate 
bleedings, twice or thrice a-week, according to the force of the pulse 
and habit of the patient, are essential, aided by blisters to the breast 
and back, and employing, at the same time, a cooling regimen. 

In almost every species of the disease, blisters or issues are often 
a means of relieving the cough ; for even when they have no ten- 
dency to remove the stimulating cause producing cough, as when it 
arises from a tubercle, yet they diminish the effect of the stimulus. 
They are particularly useful in that period of the disease, when a 
catarrhal has a disposition to degenerate into a phthisical affection; 
for in that modification of the disease, derivation from the lungs is 
of the utmost consequence. By this means, a change may often be 
effected in that state of suppuration which takes place from the in- 
ternal membranes of the lungs, and the purulent discharge may thus 
be converted into the natural mucus. 

Among other remedies in consumption, the use of emetics is 
strongly recommended. By the action of vomiting, the blood is 
propelled to the extreme vessels in every part of the body, particu- 
larly to the extreme vessels of the surface. Thus, there is produced 
a derivation from the lungs, and a consequent change in the state of 
suppuration at that part of the system ; but they are chiefly useful 
in consumption, as obviating symptoms, particularly cough and diffi- 
culty of breathing, and by promoting expectoration. 

A considerable variety of medicines of the refrigerating kinds have 
been strongly recommended for combating consumption in its in- 
cipient state. They tend to diminish the impetus of circulation, 
and although they do not immediately remove a plethoric state, yet 
they, perhaps, tend to diminish the inflammatory diathesis even 
more effectually than the repeated blood-lettings. The cooling 
neutrals, through the whole course of the disease, are useful ; par- 
ticularly nitre, which may be advantageously taken in any period 
of the complaint. Demulcents are always indicated, and usually 
employed in the manner we have recommended under the head of 
cold, to sheath the fauces, and lessen the violence of cough. Gum 
Arabic held constantly in the mouth, will also be found extremely 
useful in relieving this distressing symptom. 

Of all the remedies which have of late been fashionable in con- 
sumption is the foxglove, (see Materia Medical) but it does not seem 
to merit all the praises which have been given it. Under proper 
management, the foxglove produces a slowness of the pulse, not 
perhaps to be obtained from any other medicine yet discovered. 
And it has been the opinion of some, that, by reducing it to the 
natural standard, from the employment of digitalis, consumption 
may be overcome. But it should be observed, that the quickness 



272 CONSUMPTION. 

of pulse in this disease is merely symptomatic, and that the reduction 
of it, even below the natural standard, can have no effect either in 
removing a tubercle, or in healing an ulcer in the lungs. Hence, 
on this ground, it is in vain to expect a radical cure from its use. 
However, as a diminution of the celerity of the pulse will somewhat 
alleviate the hectic fever, it may, in certain cases, be employed with 
advantage. The most eligible mode of using the foxglove is in a 
tincture, beginning with the dose of ten drops, and gradually in- 
creasing it to sixty to an adult, morning, noon, and night. In ex- 
hibiting this medicine, it should not, however, be given in such doses 
as to induce much sickness. 

Among other active medicines, recourse is frequently had to mer- 
cury, but unless consumption was excited by a venereal taint, we 
have never witnessed benefit from this medicine. On the contrary, 
when mercurial salivation is produced in the genuine consumption, 
it has uniformly hastened the death of the patient. 

The Iceland moss, or liverwort, has been, of late, highly extolled 
as a remedy in this complaint that readily allays cough, facilitates 
expectoration, abates hectic fever, and quiets the system without con- 
stipating the bowels. It is likewise said to strengthen the organs of 
digestion, without increasing the action of the heart and arteries. In- 
deed, the physicians of Europe have spoken so loudly in its praise, 
that eveiy patient ought certainly to give it a trial. The most ap- 
proved method of using it, is in the form of decoction ; an ounce of 
the herb to a quart of water, boiled for fifteen minutes over a slow 
fire, to which two drachms of sliced liquorice-root may be added 
about five minutes before it is taken off. 

A tea-cup full of this decoction should be taken four times a-day. 
Another form is by boiling two drachms of the herb in a pint of milk 
for ten minutes, and taking it for breakfast and supper. If choco- 
late be preferred, it may be blended with it, by making the choco- 
late with a decoction of the moss, without the liquorice, as above 
directed. 

Of all our indigenous plants, the Indian turnip, (see Materia 
Medica,) has the highest reputation as a remedy in consumption. 
It is evidently an active expectorant, and may be useful in the latter 
stage of the disease. 

In the treatment of this disease, balsamic medicines are frequently 
resorted to. They are totally unsuited to the inflammatory state of 
any one of the complaints of the lungs, whether acute or chronic. 
Action having been sufficiently subdued by depletory measures, they 
may be safely and advantageously administered in catarrhal con- 
sumptions and protracted coughs ; and will be found particularly 
useful when expectoration is checked from debility, and a want of 
irritability of the glands. So opposite are the states of the lungs in 
catarrhal affections, that it requires essentially different substances to 
produce expectoration. It may be depressed or imperfectly per- 
formed, by a constriction of the lungs ; by the removal of which, an 






CONSUMPTION. 273 

infinite degree of relief is often afforded. It is also apparent that the 
lungs, occasionally from extreme debility, pour out an excessive dis- 
charge ; and that by direct stimulation of the exhalents, the effusion 
is abated and oppression removed. 

The advantages of the vegetable balsams, as they have been 
called, were supposed to consist in their power of promoting the 
healing of wounds and ulcers. At one time, many of them were 
highly extolled in pulmonary consumptions ; but each have had 
their day of fashion, and have each fallen into deserved neglect. 
According to the testimony of Drs. Duncan, Simmons, and other 
eminent physicians, gum-myrrh, exhibited in doses of twenty or 
thirty grains thrice a-day, united with an equal quantity of nitre, 
has, in many instances, been employed with the best effects in this 
intractable disease. 

While, for resolving tubercles or healing ulcerations in the lungs, 
many medicines have been taken internally, some modes of cure 
have been recommended with the view of acting topically on the 
diseased parts. In this way, different articles have been directed to 
be inhaled into the lungs, under the form of vapour. In an inflam- 
matory state of the bronchial glands, warm water vapour may be 
useful, and vinegar has occasionally been added ; but it seems often 
to irritate the cough, and the more stimulant vapours are evidently 
injurious, except where expectoration is difficult and deficient. In 
cases where the accumulations of the chest are owing to debility of 
the lungs, or are retained by the viscidity and tenacity of the matter, 
sulphuric ether is strongly recommended ; and, we are told, upon 
the high authority of Dr. Pearson, that its powers are improved by 
several substances which are soluble in it. Hemlock is particularly 
praised, half a drachm of which is to be digested in an ounce of ether, 
for several days, so as to form a saturated tincture ; of this, two or 
three tea-spoons full are to be put into a wine glass, to be held up to 
the mouth, and inspired till the whole is evaporated and repeated 
several times in the day. 

Similar in its effects to these inhalations, is the practice of smoking 
tobacco, the stramonium, and other substances. 

With the same views, tar fumigations, according to a distinguished 
Russian physician, Dr. Crichton, of St. Petersburg, have been em- 
ployed, and, it is said, with triumphant success. The mode he re- 
commends for doing this, is, to put the tar in an earthen vessel over 
a lamp, or heated iron, so as to cause a volatilization, till the air of 
the room is sufficiently impregnated, and this process is to be re- 
peated three or four times a-day. 

Having stated the remedies which have been most highly recom- 
mended in consumption, and from which, when properly adapted to 
the circumstances of the case, there is the best chance of recovery. 
we will conclude with a few remarks on the means of obviating 
urgent symptoms. 

It is a fortunate circumstance, that even in those diseases where 
35 



274 CONSUMPTION. 

the prospect of recovery is the most faint, and where there is next 
to certainty of an approaching dissolution in no long time, we still 
have it in our power to protract the period of life, and to alleviate 
the distress of the patient. In many cases of this terrible disease, it 
is all that we can reasonably expect to accomplish. 

Although colloquative sweats are not productive of pain, yet they 
tend very much to debilitate the patient, and by the loss of strength, 
the chance of recovery is very much diminished. Hence the ne- 
cessity, in such cases, of giving some tonic, as the elixir vitriol or in- 
fusion of bark. 

In every instance of consumption, it is of importance to prevent 
costiveness, and it is always a desirable circumstance to keep the 
bowels in a soluble state, which should be obtained rather by diet 
than medicines. But when diarhcea occurs spontaneously, this 
should in like manner be restrained by shunning the use of those 
articles which are observed to increase it, and by employing what 
are found to moderate it. 

Of all the symptoms which require to be mitigated, there is none 
which more frequently demands attention, than the cough. For 
this purpose an almost infinite variety of articles, either of the demul- 
cent or sedative kind, (see Cold,) may be employed with advantage. 
But of these substances, after the inflammatory symptoms have been 
subdued, none is so useful or so powerful as opium. This article, 
however, valuable as it is, cannot be considered free from inconve- 
nience. There are some individuals with whom, from peculiarity 
of constitution, it always disagrees, producing confusion in the head, 
vertigo, sickness at the stomach, and various other distressing symp- 
toms. In these cases the solution of sulphate or acetate of morphine 
might be given with advantage, as it is free from most of the objec- 
tions j ust mentioned. ( See Dispensatory.) Recourse has, however, 
been had to a variety of other sedatives, both with the view of allay- 
ing inordinate action, and of procuring sleep. Of all the substitutes 
for opium, none, according to the testimony of one of the most cele- 
brated and distinguished physicians in England, Dr. Duncan, equals 
the preparations formed from the common garden lettuce. (See 
Materia Medica.) 

It has been supposed, that by the continued use of opiates, we 
might allay irritation, and contribute to the great object, the healing 
of the ulcer. They have, however, failed in this view, though we 
cannot refuse their employment to lessen pain, and keep up the calm 
serenity, the pleasing delirium, in the midst of distress, and a state 
of hopeless of relief. 

From what has been said of the principal remedies recommended 
in consumption, the reader will find but little encouragement to in- 
dulge a hope of relief. He will probably exclaim, Is consumption, 
then, never cured ? Whence can arise the confident promises which 
every newspaper offers, and which the most respectable authorities 
confirm ? The deception arises from two sources. Catarrhal com- 



CONSUMPTION. 275 

plaints are, in many instances, confounded with consumptive, and 
the most experienced eye is occasionally deceived. In some cases, 
also, vomicae are completely evacuated by expectoration, and the 
wound heals. So insidious is the attack of consumption, that it has 
often been taken for catarrh ; and, on the contrary, so violent is often 
a catarrh, that it has been pronounced to be truly phthisical, by 
practitioners of judgment and experience ; nor has the delusion been 
destroyed but by expectoration. From such errors it is not to be 
wondered that so many medicines should have gained credit in the 
cure of consumption. To say, however, that this disease is never 
cured would certainly appear rash; for instances have occurred in 
which a recovery has been perfected by nature ; but they are so few 
that they can scarcely inspire hope. 

Regimen. — Perhaps a greater number of cures in consumption 
have been effected by regimen than by medicine, especially if under 
this head be included, not merely diet, but air, exercise, and similar 
circumstances. 

It has been but too common to prescribe the same diet in every 
stage of the disease, which has been attended with the most perni- 
cious effects, and has often hastened the death of the patient. While 
the Brunonian fed his patients to avoid debility, the other practition- 
ers carried apparently their antiphlogistic system too far. In judging 
of that diet which is best suited to phthisical patients, due attention 
must always be paid to its effects upon the system. While a con- 
siderable discharge by blood-letting is requisite, it is certainly proper 
to avoid those articles which can furnish a large supply of rich chyle, 
even, although they should be, like milk, of the very mildest nature. 
But after the suppuration takes place, and there is a free discharge 
of purulent matter, the antiphlogistic plan should be pursued no far- 
ther; on the contrary, a more nutritious diet is essentially necessary. 
The healing of tuberculous ulcers in the lungs, as well as of scrofu- 
lous sores at other parts, is only to be expected from recruiting and 
giving vigour to the system. In this state of the disease, therefore, 
a nutritious diet is naturally indicated; and, indeed, the evident 
marks of exhaustion point out the propriety of a due supply. Be- 
sides these particulars, a liberal and nutritious diet is often mani- 
fested in this stage of the disease by the feelings of the patient ; for it 
is by no means uncommon to observe even a craving for animal 
food ; and it may be remarked, that in very rare instances only are 
such calls of nature entirely to be neglected. 

The diet in the inflammatory stage of consumption should be light, 
and composed of articles that tend to correct acrimony, and diminish 
inflammation, as milk, butter-milk, rice-milk, arrow-root, sago, fruits 
of every kind, and vegetables. In the advanced stage of the disease, 
and when the pulse is weak, a more cordial and stimulating- diet, 
and strengthening remedies are necessary. To prevent weakness, 
and other ill effects of an empty stomach, patients should partake 
frequently of meat, with wine, porter, or toddy ; raw oysters are 



276 INCONTINENCE OF URINE. 

thought to be peculiarly proper. With this cordial diet, tar pills, 
bark, and elixir vitriol, or an infusion of the inner bark of the wild 
cherry tree, or hoarhound, and bitters of all kinds, have been ex- 
ceedingly useful in this state of consumption. 

Air and situation are apparently objects of considerable impor- 
tance, in a disease where medicine must confess the utility of her 
resources. Change of air is among the remedies constantly recom- 
mended ; and to change is often professedly the only object. 

Exercise, when not carried to fatigue, in a dry country air, often 
does more good than medicine ; and, consequently, should always 
be taken. 

Long journeys on horseback are the most effectual modes of exer- 
cise, carefully avoiding night air, and the extreme heat of the day 
in summer. That this exercise may not be carried to fatigue, pa- 
tients should, at first, travel only a few miles a- day, and gradually 
increase the distance as they increase their strength. When exercise 
on horseback cannot be supported, sailing and swinging should be 
substituted, and no efforts to cheer the spirits, or innocently to amuse 
the mind, should be neglected. 

Great care should be taken to regulate the dress according to the 
changes of the weather. The chest, in particular, should be de- 
fended from the cold, and the feet from the damp. In the various 
stages of this disorder, the bowels ought to be kept moderately open 
by emollient clysters, or the mildest laxatives, if the diet should not 
have the desired effects. 



INCONTINENCE OF URINE. 

Symptoms. — An involuntary evacuation of urine. 

Causes. — A relaxation of the sphincter of the bladder; injuries 
received about the neck of the bladder ; pressure of the womb in a 
state of pregnancy, &c. 

This sometimes proceeds from atony of the neck of the bladder : 
then a blister on the lower portion of the back with fifteen drops of 
the tincture of flies internally three times a-day will be of service 
with cold bathing. The sixteenth part of a grain of strychnine twice 
a-day has been attended with much benefit. When it arises from 
acrid urine diluent drinks should be used, together with the catheter. 
If there be a superabundance of lithic acid, alkalies should be em- 
ployed and tepid water injected into the bladder. When there is 
much irritation about the bladder and urethra, pills of camphor and 
hyoscyamus one grain each should be used. Fifteen drops of tur- 
pentine three times a-day have been given with decided benefit 



DIFFICULTY OF URINE. 277 

' Incontinence of urine (says Mr. Charles Bell,) never takes place 
but when the boy is asleep upon his back ; and the cure is a simple 
one. He is to accustom himself to sleep upon his face or side : the 
urine is not passed, nor is he excited to dream of making urine while 
he keeps this position. The circumstance is unaccountable, until 
we reflect on the position of this master-spring of the muscle of the 
bladder. When a person lies upon his belly , the urine gravitates to 
the fundus ; but when he lies upon his back, it presses upon this 
sensitive spot, and distends that part of the bladder which is towards 
the rectum." 

Treatment. — When the disease proceeds from a relaxation of 
the sphincter of the bladder, a large blister to the os sacrum, or lower- 
most part of the back-bone, will be found highly beneficial, and 
often effects a cure in one or two days. 

The cold bath, or dashing cold water upon the genitals, and tonic 
medicines, as the nitric acid, lime-water, bark, steel, and Columbo, 
are peculiarly proper in obstinate cases of this kind. The tincture 
of cantharides, in doses of ten or twelve drops, every three or four 
hours, is said, by Dr. Morton, to be a specific in this complaint. 
Others recommend alum whey, made as strong as the stomach will 
bear it, and direct half a pint to be taken night and morning. With 
others, the blue vitriol, in doses of half a grain, given twice a-day 
in any agreeable liquor, is most to be depended on. The occasional 
use of rhubarb, in small doses, to keep the bowels easy, tends greatly 
to alleviate the affection. When it is produced by an impregnated 
womb, little more can be done than observing a horizontal position 
as much as possible. 



DIFFICULTY OF URINE. 

When there are frequent uneasy urgings to void urine, and it is 
discharged with difficulty and pain, the disease is called a strangury ; 
and when it is totally retained, is called a suppression of urine. 

Causes. — It arises from a variety of causes, as calculous concre- 
tions ; obstructions in the urethra ; blisters ; or the tincture of can- 
tharides, taken internally too freely ; wounds, bruises, &c. 

Treatment. — The cure must greatly depend on the cause. If 
the pulse be full and feverish, bleed and procure stools by emollient 
clysters and cooling laxatives, such as castor oil, or the cathartic 
mixture. (See Dispensatory.) Much dependence is to be placed 
in the free use of demulcent drinks, as barley-water, flax-seed tea, 
mucilage of gum Arabic, decoction of marsh-mallows, of parsley 
roots, or of watermelon seeds, especially if the affection be owing to 



278 DIFFICULTY OF URINE. 

the cantharides, or any injury of the bladder. One of the cam- 
phorated powders, (see Dispensatory,) given every three or four 
hours, in the patient's common drink, often effects a cure. — Great 
relief will be obtained from the warm bath, used oftener or seldomer 
as the case may require, or sitting in a tub of warm water, or from 
the frequent applications to the belly, of cloths wrung out of hot 
water, or bladders half filled with it. Opiates are very serviceable, 
but should never be used in the height of fever. 

A starch clyster, with laudanum, has very frequently given im- 
mediate relief. Cooling laxatives and diuretics, which operate 
without any stimulus, particularly the Epsom or Glauber salts, as in 
the form of the cathartic mixture, often relieve. As a diuretic, the 
following mixture is considered most salutary. Take, of sweet 
spirits of nitre, one ounce, laudanum and antimonial wine, each, two 
drachms, a table-spoonful of which may be given in some diluent 
drink, and half this quantity repeated every hour, if necessary. 

In the chronic strangury, after other means have failed, the use 
of calomel in small doses, or mercurial ointment rubbed into the 
thighs every night till a slight ptyalism ensues, has frequently ef- 
fected a permanent cure. In such cases an affection of the prostrate 
gland may be suspected to have been the cause. Walking on a 
cold wet floor, perhaps dashing water against the legs and thighs, 
would, in obstinate cases, succeed in procuring a discharge of urine, 
as it has done the faeces. When a suppression of urine arises from 
partial palsy, as frequently occurs in the old and debilitated consti- 
tutions, our best chance of success, in giving temporary relief, is to 
give the spirits of turpentine in pretty large doses, make use of general 
stimulants, and apply a large blister to the loins. 

When this complaint is in consequence of calculous concretions 
or gravel obstructing the urinary passages, which may be known by- 
pains in the loins, sickness at the stomach, and sometimes a dis- 
charge of bloody urine, an infusion of wild carrot-seed, sweetened 
with honey, as also the infusion of peach leaves, (see Materia Me- 
dica,) have been found exceedingly beneficial. The infusion of 
hops, which is considered a solvent of the stone, administered in 
doses of a wine-glass full, and taken to the quantity of a pint daily, 
is said to be an excellent remedy in calculous affections. The uva 
ursi is likewise celebrated as a remedy in cases of gravel, in doses of 
five grains with half a grain of opium, thrice a-day. A more power- 
ful medicine, however, for gravel complaints, is the caustic alkali, 
or soap-lees, (see Dispensatory,) but, being of an acrid nature, it 
ought always to be given in mucilaginous drinks, and commenced 
with small doses, which should be gradually increased as far as the 
stomach can bear, and continued for a long time, particularly if there 
should be an abatement in the symptoms. 

When great pain attends a suppression of urine, and the bladder 
is full, which can be ascertained by feeling it above the os pubis, and 
on pressure creating pain in the neck of the bladder, or at the end 



HEMORRHOIDS, OR PILES. 279 

of the penis, it will be necessary to have recourse to the catheter, or 
a hollow bougie for drawing off the water. The larger sizes of each 
are more easily introduced than the smaller, as they are not so liable 
to stop in the corrugations and foldings of the urethra, which occur 
in elderly men. It is easy to introduce the catheter into the female 
bladder, since the direction of the urethra is nearly straight ; but in 
males there is greater difficulty. The celebrated Heister directs the 
man to lie on his back, and the operator to take the penis in his left 
hand as he stands on the patient's left side, reclining the penis to- 
wards the navel, then he is to introduce the catheter, thoroughly 
oiled, with its concave part to the belly, in the urethra, as far as the 
os pubis, and so thrusting it under the symphysis of those bones, and 
moving the hand gently outwards, forces it into the bladder. 

In the following cases, this instrument cannot be used : — When 
the neck of the bladder is greatly inflamed ; when a scirrhosity or 
preternatural tumour of the prostrate gland or stone obstructs the 
passage ; when the uterus is remarkably prominent and pendulous 
over the pubes; or when the uterus is retro verted; in which state it 
drags the bladder upwards and backwards. 

When the application of blisters causes a difficulty of urine, wash 
the blistered part frequently with warm milk and water, or apply 
sweet oil. In children, a suppression of urine is often relieved by a 
poultice of raw onions or radishes applied to the bottom of the belly. 

Regimen. — During the violence of this complaint, the lightest diet 
only should be used, and mucilaginous drinks taken freely. Those 
who are often afflicted with it, ought carefully to avoid aliment hard 
of digestion, flatulent, or of a heating nature. 



HEMORRHOIDS, OR PILES. 

When there is a discharge of blood from the hemorrhoidal veins, 
it is called the open or bleeding piles ; and when, instead of this 
hemorrhage, there are painful tumours at the lower part of the 
rectum, it is called the blind piles. 

Causes. — Costiveness; strong aloetic purges; much riding; or 
sedentary habits. 

Treatment. — If the patient be of a full habit, bleed, keep the 
bowels gently open with Epsom salts, the cathartic mixture, cream 
of tartar and sulphur or molasses and water; and avoid violent ex- 
ercise, high-seasoned dishes, and every thing of a stimulating nature. 
Topical applications, as cloths wrung out of cold vinegar and water, 
or lead- water, are also useful, and should not be omitted in either 
case. When the piles are of the bleeding sort, and will not readily 



280 HEMORRHOIDS, OR PILES. 

yield to the above means, apply cloths dipped in charcoal powder, 
or in a strong solution of white vitriol or alum, frequently to the 
fundament, or anoint the part with the hemorrhoidal ointment, {see 
Dispensatory^) and endeavour to restore the tone of the vessels by 
the use of bark, elixir vitriol, nitric acid, or tincture of rust or steel. 
When the disorder assumes a chronic form in the more advanced 
periods of life, or when the piles do not bleed, they are generally at- 
tended with considerable pain ; in which case, dossils of lint dipped 
in olive oil may be applied, or olive oil with an equal portion of lau- 
danum, may be spread on soft rags and retained by the T bandage. 
In addition to this mode of treatment, when the tumours are very 
painful, it is necessary to sit over the steam of hot water, which sel- 
dom fails to produce immediate relief. The poke- weed (see Mate- 
ria Medica,) has, in some instances, been employed with good ef- 
fects. The balsam copaivi, in doses of a tea-spoonful night and 
morning is said to be useful in relieving the pain, and will sometimes 
effect a permanent cure. According to Dr. Thomas, the tincture of 
foxglove, given in pretty large and frequent doses, is a remedy both 
for the external and internal piles. 

When the tumours will not yield to the external applications above 
recommended, anoint them night and morning with the mercurial 
ointment, to which may be added one-fourth opium. 

If the blind piles encompass the anus so as to prevent the dis- 
charges by stool, and prove otherwise troublesome, the largest may 
be removed by a ligature. If the distend vein is high and inflamed, 
it may be opened with a lancet. When from long- continued piles a 
fistula is apprehended, Ward's paste is sometimes useful. It consists 
of a pound of elecampane root, with half as much black pepper, and 
a pound and a half of fennel seeds, made into a paste with honey. 
Perhaps the remedy of the honourable John Taliaferro, for whitlow, 
might be useful in this case. 

When the piles are apparently continued from relaxation, two. 
drachms of the tincture of steel, with nearly the same quantity of 
laudanum, and four ounces of Darley-water or thin starch may be 
injected as a clyster, morning and night. 

The following ointment has been found a valuable remedy. Sul- 
phate of zinc two scruples. Powdered opium one drachm. Pow- 
dered galls one drachm. Mercurial ointment, one ounce. In cases 
of blind piles, the following ointment has afforded instant relief. Oil 
of almonds an ounce. Extract of stramonium half an ounce. Sul- 
phate of morphia six grains. To be used as an ointment. The fol- 
lowing may also be employed. Opium one drachm. Galls two 
drachms. Simple cerate an ounce. In a very obstinate case of 
blind piles, the following powder has been of great service. Pow- 
dered oyster shells and burnt cork equal parts. Anoint the part 
with a little olive oil and dust the part with the powder. When 
every thing else has failed it must not be concealed that Hey's lini- 
ment has occasionally worked miracles. One tea-spoonful of Epsom 



28i 

salts should be taken every morning to keep the bowels in a soluble 
state without operating enough to irritate. In all cases where debility 
attends, the sulphate of quinine should not be omitted. 

Prevention. — Those who are subject to this distressing com- 
plaint, may be assured of preventing its recurrence, by keeping the 
bowels in a soluble state, with the occasional use of sulphur at bed- 
time, by washing the fundament night and morning with the boldest 
water, and by making use of a sponge absorbed with cold water, af- 
ter obeying the calls of nature. 



DYSENTERY, 

OR BLOODY FLUX. 



Symptoms. — A discharge of mucus by stool, often bloody ; vio- 
lent gripings ; pain in the loins ; a constant inclination to go to stool, 
without being able to void any thing ; and sometimes fever. 

Causes. — Putrid air and aliment ; green fruit ; strong cathartics ; 
obstructed perspiration, and whatever increases the natural irritability 
of the intestines. 

Treatment. — To conduct the patient safely through this disease, 
the bowels should be evacuated by calomel, castor oil, or the cathar- 
tic mixture, and if the patient be of an inflammatory disposition, or 
there be febrile symptoms, blood-letting will also be required. After 
the acrid contents of the stomach and intestines have been evacuated, 
the anodyne sudorific bolus or draught, (see Dispensatory,) may be 
given at bed-time; and on the following day, if there be no evacua- 
tion of a natural appearance, one or other of the above aperient 
medicines must be exhibited in small doses, until the desired effect 
be obtained. 

To produce the natural evacuation daily, is a circumstance of the 
greatest importance in this disease, and should, at all times, be kept 
in view. To neglect this, as my good old friend, Doctor Henry 
Stevenson, of Baltimore, used often to say, would be like " Locking 
the thief in the house, to do all the mischief he could." It is some- 
times proper, instead of bleeding, to give an emetic in the beginning 
of the disease, to persons of weak habits ; but where there is a groat 
degree of irritability of the stomach, or obstructions of the liver, vo- 
miting will do more harm than good. 

It is my usual practice, at the commencement of this complaint, 

(o administer to adults about a scruple of calomel, conjoined with 

five or six grains of ipecacuanha, or a grain of tartar emetic, and a 

few hours afterwards, or if the medicine be taken at bed time, on the 

36 



282 



DYSENTERY, OR BLOODY FLUX. 



next morning, to give a small dose of Epsom salts or castor oil. 
With children calomel, in large doses, united with a small portion 
of ipecacuanha, are the principal medicines I employ, as it is difficult 
to prevail on them to swallow either the salts or castor oil. This 
mode of practice, together with a plentiful exhibition of arrow-root, 
the occasional use of the warm bath, and after the inflammatory 
symptoms subside, an opiate at bed-time, has uniformly succeeded. 
When the febrile symptoms justified the use of the lancet, it was, of 
course, resorted to in the early stage of the disease. By conjoining 
the ipecacuanha with calomel or opium, a determination to the skin 
is produced, which is very desirable in this complaint. It should be 
remarked, however, though diaphoretics are indispensable, yet the 
patient should not be suffered to sweat profusely. The object is 
rather to produce a general relaxation, than to weaken by the dis- 
charge. A soft pulse, and moist skin, are the chief signs of the 
good effects of the remedies employed, and of a certain amendment. 

When the disease is epidemic, after having premised the necessary 
evacuations, calomel is most to be depended on, in doses of four or 
five grains, combined with Dover's powder, the anodyne sudorific 
bolus, or with one or two grains of opium alone, exhibited every 
night. And when the calomel does not produce a natural evacua- 
tion, it is always proper to give a small dose of Epsom salts, castor 
oil, or one or two wine glasses of the cathartic mixture, every morn- 
ing, until the disease begins to yield. 

If acidity prevails in the stomach and intestines, as marked by 
oppression, heat, sour belching, and vomiting, and excoriations about 
the fundament, besides a liberal use of mucilaginous and sheathing 
drinks, a wine-glass full of the absorbent mixture, (see Dispensatory ,) 
or a spoonful or two of new milk and lime-water, should be given 
every two or three hours. Frequent injections of cold water alone 
or flax-seed tea, or barley-water, with a table-spoonful of laudanum, 
are of infinite service when the pain in the bowels and tenesmus are 
distressing. 

In obstinate cases, or when there is the least apprehension of an 
inflammation of the bowels, the warm bath or local fomentation to 
the belly, and afterwards, a blister, are indispensable. At the close 
of the disease, or when it indicates symptoms of the putrid nature, 
the charcoal, Columbo, quinine, bark, and wine, are the appropriate 
remedies; and, as a purge, rhubarb maybe employed. Children 
that have been very much emaciated by this disease, have been most 
wonderfully restored to health, by bathing them night and morning 
in a strong decoction of oak bark, (see Materia Medica,) impreg- 
nated with whiskey or common spirits, and by putting on them bark 
jackets, as advised in the ague and fever. 

Doctor Mosely, a physician of great celebrity, states, that in chronic 
dysentery, unattended with fever, there is not a more efficacious 
medicine than the vitriolic solution, (see Dispensatory/,) in doses of 
a table-spoonful every morning, with an opiate at bed-time. 






DYSENTERY, OR BLOODY FLUX. 283 

In preparing this solution, the proportion of either the vitriol or 
alum may be increased or diminished according to circumstances ; 
that is, when evacuations are required, the quantity of alum may 
be diminished, or entirely omitted*; and when great astringency is 
required, the quantity of alum is to be increased, and the vitriol 
diminished. 

A simple, though efficacious remedy in this disease, is a solution 
of common salt in vinegar or lemon juice, termed anti-dysenteric 
mixture. (See Dispensatory.) This medicine has also been 
strongly recommended in bilious fever, or putrid sore throat, when 
the bowels are in an irritable state. Dewberry is likewise a valua- 
ble medicine in this distressing disease. (See Materia Medica.) 

Regimen. — In the violence of this disease, the diet should consist 
only of arrow-root, sago, panado, or gruel, and the drinks of a cool- 
ing and sheathing nature, as barley or rice water, flax-seed tea, or 
mucilage of gum Arabic, or sassafras. (See Materia Medica.) But 
when the disease has existed some time, the diet should be more 
nourishing, particularly if the patient has been weakened by preced- 
ing disease, or is either of a tender or an advanced age. Oranges, 
and whatever ripe fruit the season affords, may be allowed. 

The room should be constantly fumigated with vinegar, and well 
ventilated. The clothing, as well as the bedding, ought to be often 
renewed, and all offensive odours, particularly the feeces, should be 
removed as speedily as possible. 

Prevention. — The same means of prevention are here to be 
used, as under the head of bilious; and, as this disease becomes 
infectious, by neglect of cleanliness, its farther progress, through the 
medium of bad air, may be checked by attending to the mode of 
purifying that element prescribed under the head of nervous fever.* 

* It was this disease, which carried from the honours of this, to the glories 
of a better world, the illustrious author of the Declaration of Independence, 
Thomas Jefferson. His disorder assumed a serious character on the 26th 
of June, 1826. The strength of his constitution and his freedom from pain, 
for a short time, encouraged the hope that his illness was merely temporary- 
He himself, however, felt the conviction, that his last hour was approaching. 
He had already lived beyond the limit ordinarily assigned to human existence, 
and, for some months past, he had looked forward to its termination, with a 
calmness and equanimity worthy of his past life, nunc dimittis domine, &c. 
"Lord, now lettest thou thy servant depart in peace," the beautiful ejacula- 
tion of the just and devout Hebrew, was his favourite quotation. On the 2d 
of July, the complaint left him ; but his physician expressed fears that his 
strength might not prove sufficient to restore him from the debilitated state to 
which he was reduced. Conscious that he should not recover, and free from 
pain, he calm]y gave directions relative to his coffin and interment, which he 
requested might be at Monticello, without pomp and parade. On Monday, 
the following day, he inquired with much solicitude, of those around him, 
what was the day of the month? On being told that it was the 3d day of 
July, he eagerly expressed his desire that he might be permitted to live vet a 
little while that he might breathe the air of the fiftieth anniversary. His de- 
sire was gratified. He was sustained up to the very moment when his wishes 
were complete, and was then borne to that world, where the pure in heart 



284 APOPLECTIC FITS. 



APOPLECTIC FITS. 

Symptoms. — Sudden falling to the ground, with a deprivation of 
sense and motion, attended by deep sleep and noisy breathing, the 
circulation remaining unimpaired. 

Causes. — Plethora; hard drinking; too large doses of opium; 
blows ; tight neck-cloths, or whatever interrupts the return of the 
blood from the head. 

Treatment. — In the cure of a disease threatening such sudden 
fatality, remedies must be speedily employed. The patient's head 
should instantly be raised and supported, and he be placed in a 
situation where he can respire a cool air. He is to be bled most co- 
piously, to the amout of a quart or more, and this must be repeated 
after a short time, if he is not relieved, especially if the disease occur 
in a person of robust and plethoric habit. Cup also on the temples. 
Brisk purges are next to be administered, and when these cannot be 
swallowed, the most stimulating injections should be thrown up. 
The Croton oil, (see Dispensatory ,) will in these cases be valuable; 
for when the patient is unable to swallow, from one to two or three 
drops, dropped on the tongue, will soon find its way into the stomach, 
and produce the desired effect. 

Where the disease depends rather on a depletion of the blood 
vessels, than on too great fulness, which may be known by its at- 
tacking old people of debilitated habits, bleeding is sparingly to be 
resorted to, particularly if the countenance appear to be sunk and 

meet their God. Of Mr. Jefferson's public virtues and services, it were su- 
perfluous for the author to speak. History has taken charge of them. His 
excellent and amiable life, his warm and unvarying attachment to his friends, 
his liberal and unaffected hospitality, and his singular moderation and equa- 
nimity are also known to all, and by all, and are held in pleasing but mournful 
remembrance. None was ever more illustrious in life; none was ever more 
happy in death. 

On the same day died the venerable compatriot of Mr. Jefferson, the Ex- 
President, John Adams. Mr. Adams felt the gradual decay of age affecting 
his body rather by insensible degrees, than by any settled infirmity. He did 
not, till a few days before his death, show any indication of a more rapid de- 
cay of health than usual. The fourth of July found him unable to rise from 
his bed, on account of an unusual degree of debility. Roused by the sound 
of distant artillery, he said, " It is a glorious day." Being afterwards asked 
for a toast, to be drunk by his neighbours, he said, ** I will give them Indepen- 
dence for ever" These were his last intelligible words; about four o'clock, 
in the afternoon, this ancient patriot joined the throng of "just men made 
perfect." Great and glorious was the- consummation of these renowned 
founders of American liberty. They finished their course, when they reached 
the jubilee of that independence which they had, in so great a measure, con- 
tributed to establish. They departed, (to use the language of our present 
honoured Chief Magistrate, the distinguished son of John Adams,) cheered 
by the benedictions of their countrymen, to whom they left the inheritance of 
their fame, and the memory of their bright example. 



■H 



EPILEPTIC FITS. 285 

pallid. In these cases, the patient ought to be laid on a bed, with 
his head elevated, and turned every hour. Clysters are then to be 
given, and as soon as liquids can be swallowed, the contents of the 
stomach and bowels should be evacuated by a brisk purge. 

Sinapisms and blisters to the extremities, should not be neglected. 
But scalding or searing the soles of the feet with a hot iron, will 
more certainly and suddenly rouse the torpid system. 

Regimen. — The diet should be of the lowest kind, consisting 
principally, for several days after the attack, of diluent drinks, such 
as rice or barley-water, tamarind-water, or flax-seed tea, &c. 

Prevention. — In full habits, let the diet be light and sparing, 
and the bowels kept open. In debilitated habits, the diet should be 
more nourishing, and the strengthening medicines, as bark, steel, 
&c, employed to give tone to the vessels. 



EPILEPTIC FITS. 

Symptoms. — The patient falls suddenly with a deprivation of 
sense, while the muscles of the face and every part of the body are 
violently convulsed. 

Causes. — Excessive drinking ; sudden stoppage of the courses ; 
severe fright ; injuries of the head ; teething, in children ; and irri- 
tation from worms in the stomach and intestines. 

Treatment. — To prevent the patient from injuring himself b) 
the violence of his struggles, he ought immediately to be placed on 
a bed. The clothing should be every where loosened, and the head 
moderately elevated. A slip of wood should be placed between the 
jaws to prevent their closing on the tongue, and nothing adminis- 
tered in a glass vessel. Should it appear that the patient has beer 
drinking too freely of spirituous liquors, or has loaded his stomach 
with indigestible matter, a strong emetic should be immediately 
given ; which, by cleansing the stomach, will often terminate the 
paroxysm. 

If suppressed evacuations be the cause, they must be re-excited 
by such means as are calculated to restore the course of nature, h 
the patient complain of pain in the head, a seton in the nape of 
the neck should not be omitted. If worms be the fault, which 
may be known by an offensive breath and irregular appetite, they 
must be removed before a radical cure can be effected. 

The suppression of cutaneous affections has occasioned the dis- 
ease; the repulsion of the gout; and sometimes the deficiency of 
the constitutional strength, which prevents its formation, has had the 



286 



FAINTING FITS. 



same effect. In all these instances the knowledge of the cause will 
suggest the means of relief. 

When causes of debility and irritability, produce epilepsy; in 
other words, when the irritability is so great that the slightest 
irritation will induce the fits, the remedy is equally obvious. 
Warm, generous diet, which may appear at first indicated, must 
be used with caution ; since a fulness of the vessels is, alone, in 
tender habits, a cause of irritability. Tonic medicines, with some 
of the narcotic bitters, as hops, Iceland liverwort, and lettuce, 
are the best remedies in such cases, anxiously guarding, as usual, 
against any accumulations in the head ; but not by such medicines 
as will weaken. 

Sometimes an epileptic fit is preceded by an uneasy sensation in 
some of the limbs or trunk of the body, creeping upwards to the 
head. In this case, the fit will be prevented by applying a ligature 
above the part so affected. 

Many cases have occurred, in which this disease has been cured 
with the sugar of lead, particularly under the age of maturity. It 
should be commenced in small doses, beginning with one-fourth of 
a grain, for a half grown person, and gradually increased to two 
grains or more, thrice a-day, made into pills with the crumbs of 
bread. If from using this medicine the bowels be disordered, it 
should be laid aside until relief is obtained by the use of the bath, 
mild laxatives, and opium in more than usual doses. A small por- 
tion of opium, combined with the lead, (see Dispensatory^) will 
generally obviate or correct its unpleasant operation. 

The good effects of nitrate of silver, commonly called lunar caus- 
tic, have also been attested by eminent physicians, in doses from 
one fourth, very gradually increased to a grain, twice a-day, made 
into pills with bread. The flowers of zinc have likewise been highly 
spoken of, and are said to have performed permanent cures, in doses 
of six or eight grains, morning and night. 

As there is incontrovertible evidence, that these medicines have 
succeeded in certain cases, they are all deserving of a fair trial, par- 
ticularly in the treatment of a disease in which no plausible remedy 
should be left untried. 



FAINTING FITS 



Symptoms. — The pulse and respiration suddenly become exceed- 
ingly feeble, insomuch, at times, as to create a fear of the total ex- 
tinction of life. 

Causes.— Fright; long fasting; large evacuations; debility, &c. 



HYSTERIC FITS. 287 

Treatment. — The patient should be placed in a reclining pos- 
ture, and every part of the clothing, which by its tightness is likely 
to interrupt the free circulation of blood, must be immediately loos- 
ened. The doors and windows of the room, especially if the weather 
be warm, should be kept open, and no more persons admitted than 
are necessary to give assistance ; and these should not prevent the 
free access of the air to the patient. 

Sprinkle the face with cold water or vinegar, and apply volatiles, 
burnt linen, or feathers, to the nostrils ; and, that the stimulus may 
with more certainty be inhaled, the patient should be kept from 
breathing through the mouth, by holding a handkerchief forcibly 
against it, taking care however, to leave the nostrils perfectly free. 



HYSTERIC FITS 



This disease more frequently occurs in unmarried or barren wo- 
men, and those who lead a sedentary life. It very seldom appears 
before the age of puberty, or after the age of thirty-five years. 
The time at which it most readily occurs, is that of the menstrual 
period. 

Symptoms.— Generally commences with universal languor and 
coldness of the extremities. The colour of the face is variable, being 
sometimes flushed and sometimes pale. The pulse becomes unequal 
and obscure. The stomach is sometimes affected with vomiting, the 
lungs with difficulty of breathing, and the heart with palpitations. 
A painful sensation is often felt, like that of a globe or a ball in the 
left side of the belly, advancing upwards, and producing the same 
uneasiness in the stomach, from which it rises to the throat, occa- 
sioning by its pressure, a sense of suffocation ; when a degree of 
fainting comes on, certain convulsive motions take place, agitating 
the trunk of the body and limbs in various ways ; after which, alter- 
nate fits of laughter and crying occur, and a remission then ensues. 
In some patients, a violent beating pain takes place in some part of 
the head, as if a nail were driving into it. Sharp pains, likewise, 
attack the loins, back, and bladder, and the patient makes an unu- 
sual quantity of urine as limpid as water ; which is one of the most 
characteristic signs of the disease. 

The appearances which take place in this affection, are consider- 
ably varied in different persons, and even in the same persons at dif- 
ferent times. It differs by having more or fewer of those circum- 
stances above mentioned ; by those circumstances being more or less 
violent, and by the different duration of the whole fit. 

Causes. — Excessive evacuations, particularly of the menses, de- 



238 PALSY. 

pressing passions, continued anxiety, violent excitement, sudden sur- 
prise, grief, indigestion, &c. 

Treatment. — If the patient be young and of a plethoric habit, 
blood-letting will be required during the fit ; but in delicate consti- 
tutions, this operation is not advisable. Volatiles, singed feathers, 
and the like, should be applied to the nostrils : and if the patient can 
swallow, a tea-spoonful of ether, or tincture of assafcetida, or thirty or 
forty drops of laudanum, may be given, in a glass of cold water, and 
repeated in a couple of hours, or sooner, if necessary. Clysters of 
gruel, to which may be added a tea-spoonful or two of laudanum, 
will also have a good effect. The feet an 6! legs should, as soon as 
possible, be put in warm water, and well rubbed with the hand. Cold 
water sprinkled on the face, and the admission of the cool air in the 
room, are likewise proper auxiliaries. 

During the intermission of the fit, the nervous system should be 
strengthened to prevent a recureence, by the tonic powders, pills, or 
drops, {see Dispensatory ,) in their usual doses, after having admin- 
istered some purgative medicine. — Upon the approach of any lan- 
guor, the patient should instantly take a glass of wine, or a tea- 
spoonful of lavender, or ten or twelve drops of laudanum in a glass 
of cold water. 

When hysteric affections originate from a suppression or obstruc- 
tion of the menses, these must be promoted by adopting the means 
advised under those heads. 

Regimen. — An attention to diet is highly proper for the removal 
of this disease. A milk and vegetable diet duly persisted in, will 
have the most salutary effect, especially in sanguine constitutions ; 
but, should vegetables create flatulency and acidity in the stomach 
and bowels, in such cases animal food will be the most appropriate 
diet. The best drink after dinner is water with a little good wine, 
or a smaller quantity of old spirits. 

Tea should be prohibited altogether, or used sparingly. — Moderate 
exercise, particularly riding on horseback, is of the greatest service, 
as are likewise amusements and cheerful company. 



PALSY. 

Is a disease consisting in a loss of the power of voluntary motion, 
but affecting certain parts of the body only, and by this it is distin- 
guished from apoplexy. In the most violent degrees of palsy, the 
patient loses both the power of motion, and sense of feeling, either 
of one side or the lower half of the body. The first is termed hemi- 
plegia the latter paraplegia. When it affects particular parts only, 
as the tongue, the lip, eyelid, &c, it is termed a local palsy. 



PALSY. 289 

Symptoms. — If this disease be not the effect of apoplexy, it is 
often preceded by universal torpor, giddiness, a sense of weight or 
uneasiness in the head, dulness of comprehension, loss of memory, 
and a sense of coldness in the part about to be affected ; there is also, 
sometimes tremour, creeping, and pain in the part. 

Causes. — Compression of the brain from any of the causes in- 
ducing apoplexy ; certain poisons received into the body, as lead, 
arsenic, (fee; injuries done the spinal marrow. It is also produced 
in consequence of extreme debility, and old age. 

Treatment. — If palsy arise from the causes producing apo- 
plexy ; it must necessarily be treated in the manner recommended 
for the cure of that disease, by bleeding copiously in full habits, and 
keeping the bowels in a laxative state for many days. 

It will also be requisite to apply a large blister to the back of the 
neck, and when the discharge is lessened, others should be applied 
behind each year. After congestion is removed by this mode of 
treatment, it will then be necessary to commence with the stimulat- 
ing plan, in order to rouse the torpid vessels into action. When 
stimulants are resorted to, they should be changed every eight or ten 
days, and sometimes alternated with gentle laxatives, to prevent re- 
turns of accumulation on the brain. 

In some instances this disease arises from diminished energy of the 
brain ; and in such cases we must have recourse to stimulants, both 
internally and externally, without delay. In this state the essential 
oils and balsams are frequently employed with good effects. One 
of the most active and useful medicines of this class is the spirit of 
turpentine in doses from twenty to sixty drops thrice a-day. A table- 
spoonful of horse-radish scraped, or the same quantity of mustard- 
seed, swallowed three or four times a day, will have a good effect. 
The volatile alkali is also of infinite service in large doses. At the 
same time, external stimulants must be duly attended to, such as dry 
frictions over the part affected, with a flesh brush or rough cloths, 
and the flour of mustard, or flannels impregnated with the tincture 
of Cayenne pepper, oil of turpentine, oil of sassafras, or volatile lini- 
ment, or some of the tincture of cantharides. Stimulating the part 
with nettles has produced good effects, as well as electricity, particu- 
larly in local palsies. 

A seton in the neck, particularly if the patient be affected with 
giddiness, will afford considerable relief, and should not be neglected. 
Cases of palsy have been cured by salivation. 

If the disease be in consequence of a curvature of the back bone, 
compressing the spinal marrow, a perpetual blister or issue over the 
part affected, or on each side of the diseased portion of the bone, is 
the only remedy. A local palsy, particularly when it is confined to 
one muscle, will generally yield to the application of a blister as near 
to the part affected as possible. 

This disease has been greatly relieved by the deul iodide of mer- 
cury combined with extract of aconite in the following combination. 
37 



290 HYPOCHONDRIAC DISEASE. 

Extract of aconite one grain. Deul iodide of mercury one grain. 
Pulverized opium three grains. Extract of gentian and mucilage 
Q,. S. to make sixteen pills. One, morning, noon and night. Col- 
chicum and Fowler's arsenical solution have also been taken with 
great benefit in this complaint. More recent experience has shown 
that blood-letting in this disease is not only unnecessary, but tends 
to aggravate and to fix the very symptoms it was designed to relieve. 
The cold shower-bath every morning and evening followed by fric- 
tion over the spine with a gently stimulating liniment has been very 
serviceable. 

Regimen. — In plethoric habits the diet should be of the lightest 
kind, but quite the contrary in debilitated habits. In such cases the 
diet should be warm and strengthening, seasoned with spices and 
aromatic ingredients, and the drink must be generous wine, mustard 
whey, ginger tea, or brandy and water. Flannel worn next the 
skin is peculiarly proper ; so is regular exercise, when not carried to 
fatigue or used in a cold damp air. 



HYPOCHONDRIAC DISEASE, 

(Commonly called Vapours, or Low Spirits.) 

This complaint chiefly occurs in the male, and that at advanced 
life; and it is confined, for the most part, to persons of a sedentary 
or studious disposition, especially such as have indulged grief or 
anxiety. 

Symptoms. — Languor, listlessness, or want of resolution and ac- 
tivity, with respect to all undertakings ; a disposition to seriousness, 
sadness, and timidity, as to all future events ; an apprehension of 
the worst or most unhappy state of them, and, therefore, often, on 
slight ground, a dread of great evil. Such persons are particularly 
attentive to the state of their own health, and to the smallest change 
of feeling in their bodies, from an unusual sensation, perhaps of the 
slightest kind, they apprehend great danger, and even death itself; 
and in respect to all their feelings and apprehensions, there are, for 
the most part, unfortunately, the most obstinate belief and persuasion. 

This diseased state of mind is sometimes attended with symptoms 
of indigestion, hysterical affections, and sometimes with melancholy; 
but these are merely effects. 

Causes. — Indolence; violent passions of the mind; suppression 
of customary evacuations ; obstructions of some of the viscera, &c. ; 
but its immediate cause appears to be a loss of energy in the brain, 
or torpid state of the nervous system. It would appear, however. 



HYPOCHONDRIAC DISEASE. 291 

that these complaints proceed from an original affection of the 
stomach. 

Treatment. — The cure of this disease seems to depend on ex- 
citing the nervous energy which is depressed, and that particularly 
by attending to the state of the mind. 

A constant state of motion should, therefore, be advised, especially 
by riding on horseback, and making long journeys, which present 
new objects to the view. 

Nothing is more pernicious in this disease, than idleness; but in 
avoiding it, all application to former studies is to be prevented. The 
present emotions must be favoured and indulged : and though an 
attempt should be made to withdraw the attention of such patients 
from themselves, yet their confidence ought first to be gained ; and 
since the persuasion of their own opinion is strong, and the infalli- 
bility of their own fears and sensations rooted, however absurd these 
may be, they require a very nice management.* Raillery must 

* Some hypochondriacs have fancied themselves miserably afflicted in one 
way, and some in another — some have insisted that they were tea pots ; and 
some that they were town clocks, — this, that he had a big belly, and that, 
his legs were glass — one that he was extremely ill, and another that he was 
actually dying. But I have never heard of any of this blue-devil class, whose 
extravagance ever yet came up to the following, which was related to me by 
my noble-hearted old friend, the late Dr. Stevenson, of Baltimore, whose very 
name always sounds in my ears as the summary of every manly virtue. 

This hypochondriac, who, by the by, was a patient of Dr. Stevenson, after 
ringing the change on every mad conceit that ever tormented a crazy brain, 
would have it at last that he was dead, actually dead. Dr. Stevenson having 
been sent for one morning, in great haste, by the wife of his patient, hastened 
to his bed-side, where he found him stretched out at full length, his hands 
across his breast, his great toes in contact, his eyes and mouth closely shut, 
and his looks cadaverous. 

"Well, sir, how do you? how do you do this morning?" asked Dr. Ste- 
venson, in his blustering jocular way, approaching his bed. "How do I do," 
replied the hypochondriac, faintly — "a pretty question to ask a dead man." 
" Dead !" replied the Doctor. " Yes, sir, dead, quite dead. I died last night 
about twelve o'clock." 

Quick as lightning, Dr. Stevenson caught his cue, which was to strike him 
on the string of his character ; on which, the Doctor happily recollected he 
was very tender. Having gently put his hand on the forehead of the hypo- 
chondriac, as if to ascertain whether it was cold, and also felt his pulse, he 
exclaimed, in a doleful note, " Yes, the poor man is dead enough — it is all 
over with him, and now the sooner he can be buried the better." Then step- 
ping up to his wife, and whispering to her not to be frightened at the measures 
he was about to take, he called to the servant, " My boy, your poor master is 
dead, and the sooner he can be put in the ground the better. Run to Mr. 

C m, for I know he always keeps New England coffins by him, ready 

made; and, do you hear, bring a coffin of the largest size, for your master 
makes a stout corpse, and having died last night, and the weather warm, he 
will soon begin to smell." 

Away went the servant, and soon returned with a proper coffin. The wife 
and family having got their lesson from the Doctor, gathered around him. and 
howled no little, while they were putting the body in the coffin. Presemlv. 
the pall-bearers, who were quickly provided and let into the secret, started 



292 HYPOCHONDRIAC DISEASE. 

never be attempted. From this supposed bodily affection, the mind 
should be diverted by employments suitable to the circumstances 
and situation in life, and unattended with much emotion, anxiety, 
and fatigue. Company which engages attention, and is at the same 
time of a cheerful kind, will always be found of great service. The 
occasional reading of entertaining books, or playing at any game, in 
which some skill is required, and where the stake is not an object 
of much anxiety, if not too long protracted, will farther assist in 
diverting the mind from itself. 

The symptoms of indigestion, and hysteric complaints, that so 
frequently attend this state of mind, although the effect, rather than 
the cause, are objects of practice ; inasmuch as they tend to aggravate 
and realize the false apprehensions of the patient. The secondary 
affections require the same mode of treatment recommended for in- 
digestion and hysteric disease. The warm bath is peculiarly bene- 
ficial in this complaint, and when the system becomes somewhat 
invigorated, the cold bath may be employed with advantage, provided 
there exist no obstructions in the bowels. From an acid acrimony 
generally prevailing in the stomach, the rust of steel, or filings of 
iron, in doses of ten grains thrice a-day,is the most salutary medicine 
of all the tonics. Magnesia and lime-water are useful on the same 
account. 

Regimen. — A proper diet constitutes an essential part in the treat- 
ment of this malady. In general, light animal food is what alone 
agrees with such patients ; for there are few, if any, vegetables which 
do not prove flatulent in their bowels. — Acids are particularly inju- 

with the hypochondriac for the church-yard. They had not gone far before 
they were met by one of the towns-people,, who, having been properly drilled 
by the facetious Stevenson, cried out, "Ah, Doctor, what poor soul have you 
got there V 

" Poor Mr. B ," sighed the Doctor, " left us last night." 

" Great pity he had not left us twenty years ago," replied the other, "for he 
was a bad man." 

Presently another of the towns-men met them with the same question. 
"And what poor soul have you got there, Doctor?" 

" Poor Mr. B ," answered the Doctor again, " is dead." 

" Ah ! indeed !" said the other. "And so the devil has got him at last." 
"Oh, villain!" exclaimed the man in the coffin, "if I were not dead, how 
I would pay you for that!" 

Soon after this, while the pall-bearers were resting themselves near the 
church-yard, another one stepped up with the old question again, " What 

poor soul have you got there, Doctor?" "Poor Mr. B " he replied, "is 

gone." 

" Yes, and to h— 11," said the other, " for if he is not gone there, I see not 
what use there is for such a place." Here the dead man bursting off the lid 
of the coffin, which had been purposely left loose, leaped out, exclaiming, 
"Oh, you villain! I am gone to h — 11, am I! Well, I have come back again 
to pay such ungrateful rascals as you are." A race was immediately com- 
menced between the dead man and the living, to the petrifying consternation 
of many of the spectators, at sight of a corpse bursting from the coffin, and in 
all the horrors of the winding sheet, racing through the streets. After having 



CRAMP. 293 

rious. All malt liquors, except porter, are apt to excite too high a 
fermentation in the stomach ; and wines, for the most part, are liable 
to the same objection. If an exception can be made in favour of 
any, it is good old Madeira, when it can be obtained, which not only 
promotes digestion, and invigorates the concoctive powers, but acts, 
immediately, as a generous and wholesome cordial. The use of 
spirituous liquors is not to be recommended as an habitual resource, 
though they may be taken occasionally, in a moderate quantity, 
diluted with water. Tea and coffee, though hurtful to people 
with bad digestion, are often useful, however, to the hypochondriac. 
Moderate exercise, we have already observed, is indispensable in 
the cure of this complaint ; and it cannot be taken any way with so 
much advantage as in long journeys, when convenient, accompanied 
with such circumstances, as may convert them into an agreeable 
amusement. 



CRAMP. 

A painful spasm of the calf of the leg or muscles of the toes, and 
sometimes of the stomach. 

Causes. — Sudden stretching of the limbs; advanced pregnancy; 
acidity ; indigestion, irritation, and debility. 

Treatment. — A cramp of the calf of the leg is best relieved by 
standing up, which simple act, by throwing the weight of the body 
on the toes, forcibly extends the muscles, and thus takes off the spasm. 
If the cramp arise from acidity or indigestion, give every night a pill 
composed of half a grain of opium, with six grains each, of rhubarb 
and prepared chalk, and administer ten grains of the rust of steel, 
morning and noon. 

A cramp of the stomach is best treated by an infusion of red pepper, 
(see Materia Medica,) or a large dose of ether or laudanum, accom- 

exercised himself into a copious perspiration by this fantastic chase, the hypo - 
chondriac was brought home by Dr. Stevenson, freed of all his complaints. 
And by strengthening food, generous wine, cheerful company, and moderate 
exercise, was soon restored to perfect health. 

To demonstrate, farther, the happy effects of possessing quick wit, " to shoot 
folly as it flies," I will cite another case of hypochondriasm, which came 
under the care of that philanthropic and learned physician, the late Doctor 
Crawford, of Baltimore, who, in every thing amiable and good, was not unlike 
his intimate friend, Dr. Stevenson. 

A certain hypochondriac, who, for a long time, fancied himself dying o\' a 
liver complaint, was advised by Dr. Crawford, to make a journey to the State 
of Ohio. After an excursion of three months, he returned home apparently 
in good health: but upon receiving information of the death of a twin brother. 
who had actually died of a scirrhous liver, he immediately took the staggers* 
and falling down, roared out that he was dead, and had, as he always" ex- 



294 TETANY, OR LOCK JAW. 

panied with friction on the part, either by a flesh brush or flanne' . 
When these fail, a very copious bleeding will sometimes remove the 
spasm, after which the patient must be purged. 

The chief remedies of spasm are those which remove the irritating 
cause. If this cannot be ascertained, we must endeavour to lessen 
irritability by anodynes. A sudden terror, the apprehension of a 
severe operation, on the return of the fit, and unexpected surprise, 
have succeeded. Dashing water in the face, touching a person with 
something cold, or throwing up a cold clyster, have, from the same 
principles, been effectual. 

Persons subject to the cramp in the leg may prevent it by wearing 
stockings in bed, and occasionally rubbing the part with camphorated 
oil. According to vulgar authority, sulphur grasped in the hand, is 
good to cure, and carried in the pocket, to prevent cramp. 



TETANY, OR LOCK JAW. 

Symptoms. — A rigid and painful contraction of all or several of 
the muscles. Its first symptoms are a stiffness in the back of the 
neck, increasing to pain, extending next to the root of the tongue, 
then shooting into the breast, and, lastly, seizing the back. 

Causes. — Wounds of the head or extremities, and punctures of 
the slightest kind, as running a splinter under the nail, or into the 
toe or finger. 

It is equally induced from cold or moisture, particularly when 
sudden vicissitudes prevail, or sleeping on damp ground. 

Treatment. — On the first appearance of this disease, give one oj 
two table-spoons full of laudanum, or six or eight grains of opium 
every two hours until the symptoms abate and then the dose should 

peeted, died of a liver complaint. Dr. Crawford being sent for,, immediately 
attended,, and asked the hypochondriac how he could be dead,, seeing he could 
talk. But still he would have it that he was actually dead. Whereupon, the 
sagacious Doctor exclaimed, tf O yes, the gentleman is certainly dead, and it 
is more than probable, his liver was the death of him. However, to ascertain 
the fact, I will hasten to cut him open before putrefaction takes place." And 
thereupon, getting a carving knife, and whetting it as a butcher would to open 
a dead calf, he stepped up to him and began to open his waistcoat, when the 
hypochondriac, horribly frightened, leaped up with the agility of a rabbit, and 
crying out, i: Murder ! murder! murder!" ran off with a speed that would 
have defied a score of doctors to catch him. After running a considerable dis- 
tance, until he was almost exhausted, he halted ; and not finding the Doctor 
at his heels, soon became composed. From that period, this gentleman was 
never known to complain of his liver; nor had he, for more than twenty years 
afterwards, any symptom of this disease. 



OR LOCK JAW. 295 

be gradually lessened. Between the doses, wine or spirits should be 
given very freely. The use of the warm bath will also assist the 
efficacy of the opium. These remedies should be increased, and 
carried to the utmost extent, as the symptoms may indicate. If the 
opium cannot be swallowed, six times the quantity may be injected 
in clysters until the patient can swallow. 

This disease has oftentimes yielded to a salivation. And when 
there is time for the operation of mercury, it should be used both in- 
ternally and externally. At the same time it is advisable to give 
opium, in more moderate doses. 

Dr. Brown, who is now one of the principal professors in the 
Transylvania university, communicated some time since, through 
the medium of the New York Medical Repository, his success in the 
cure of tetanus with the tincture of cantharides. When recourse is 
had to this remed}^, give from twenty to thirty drops of the tincture 
every hour, until it produces strangury or a difficulty of urine. As 
soon as this occurs, it must be discontinued, and flax-seed or marsh- 
mallow tea or barley-water, or some mucilaginous liquid drunk 
freely, and some of it injected by way of clysters; to which may be 
occasionally added two tea-spoons full of laudanum. 

According to Dr. Nathaniel Miller, the solution of arsenic in doses 
of ten drops, with an equal quantity of laudanum, and a large 
spoonful of spirits every half hour, has, in several cases of tetanus, 
succeeded admirably in performing a cure. — When the symptoms 
abate, the dose must be diminished and the medicine gradually 
discontinued. 

Among the various remedies which have been recommended for 
the cure of tetanus, none has been employed with greater success 
than the cold bath. This is to be done by plunging the patient in 
the coldest water, or by pouring suddenly over his head and shoul- 
ders several tubs of cold water. The cold bath must be repeated 
every three or four hours, until a perfect cure be effected. 

On the decline of the spasm, bark with wine and opiates at bed- 
time should be given, until the patient's health be reinstated. 

Spirits of turpentine and infusion of tobacco (see Materia Medica,) 
have each been administered, by way of injection, with very happy 
effects in this alarming disease. 

In every stage of the disease, it is of importance to keep the 
bowels open, by the usual stimulating purgatives or clysters. 

When local injuries have been the cause of this disease, the wound 
should be dilated and filled with common salt, Spanish flies, or tur- 
pentine, and afterwards dressed with warm poultices until the wound 
be brought to a state of good digestion. If a wounded finger or toe 
be the cause of this horrible malady, it ought instantly to be cut off. 



296 PALPITATION OF THE HEART — HICCOUGH. 



PALPITATION OF THE HEART. 

Symptoms. — In this disease, the motion of the heart is performed 
with more rapidity, and generally with greater force than usual, 
which may not only be felt by the hand, but often perceived by the 
eye, and even heard : there is frequently a difficulty of breathing, a 
purplish hue of the cheeks and lips, and a variety of anxious and 
painful sensations. It sometimes terminates in sudden death. 

Causes. — A morbid enlargement of the heart itself, and of the 
large vessels; organic affections ; an hereditary disposition ; plethora ; 
debility, or a morbid condition of the system ; mal-conformation of 
the chest, and many of the causes inducing fainting. 

Treatment. — This complaint is best relieved by keeping the 
mind and body at rest, avoiding every cause of irritation, and keep- 
ing up a proper equilibrium of the circulation. 

When the disease arises from plethora, and the action of the heart 
is violent, bleeding is indispensable, which should be followed by a 
cooling cathartic, and afterwards the exhibition of nitre every two 
or three hours, or the tincture of digitalis, in doses from ten to 
twenty drops thrice a-day, by lessening the action of the arterial 
system, will effect a cure. 

When there is reason to believe this affection is in consequence of 
debility, the solution of arsenic, in its usual doses, taken for some 
time, is a certain remedy. When the nervous system is affected, 
small doses of ether, laudanum, or some cordial will be found very 
serviceable. 

The feet should be kept dry and warm, frequently rubbed, and, 
if not otherwise warm, with powdered mustard seed, or tincture of 
Cayenne pepper. 

Those who are subject to a palpitation of the heart should care- 
fully avoid violent exercise, irregular passions, costiveness, and all 
circumstances that may tend to increase the action of the sanguife- 
rous system. 



HICCOUGH. 



A spasmodic affection of the diaphragm, and sometimes of the 
stomach, is a troublesome, but not often a dangerous complaint. 

Causes. — Debility, acidity, flatulence, cold drinks when the per- 
son is warm, repletion, worms, repelled gout, &c. 



NIGHTMARE. 297 

Treatment. — When it arises, as is most frequently the case, 
from spasm induced by debilitating causes, the warm antispasmodics, 
as ether, laudanum, the camphorated mixture, hartshorn, tincture of 
assafoetida, or some of the essential oils, will be useful. A tea-spoon- 
ful of vinegar, slowly swallowed, has frequently afforded relief. 
Preserved damsons have likewise been found of excellent use in 
this complaint. 

When acidity is discovered to be the cause, give the absorbent 
mixture, or twenty drops of hartshorn, with a tea-spoonful of mag- 
nesia in a cup of mint tea, or a spoonful or two of milk and lime- 
water ; and, to prevent its recurrence, take ten grains of the rust of 
steel thrice a-day. When occasioned by poisons or improper food, 
an emetic will be proper. 

In weak stomachs, oppressed with indigestible food, a glass of 
good wine or spirits and water often relieves. Ether applied exter- 
nally to the stomach on a soft linen rag with a warm hand to con- 
fine it, is a good remedy; so is the application of an acrid cataplasm 
or blister in obstinate cases. 

Like other spasms, it is often stopped by strongly arresting the at- 
tention, whether by hope, fear, or terror. A sudden alarm has often 
succeeded in curing this affection after every other means had failed. 
On the same principle, a deep, continued inspiration will often re- 
move slighter degrees of this troublesome complaint. 



NIGHTMARE. 

Symptoms. — An alarming oppression of weight about the breast, 
with dread of suffocation. 

Causes. — Late and excessive suppers ; great fatigue ; drunken- 
ness, or sleeping on the back. 

Treatment. — If the patient be of a plethoric habit, bleed, purge, 
and use a spare diet. And when the disease is the consequence of 
debility and weak nerves, the tonic medicines, as steel, bark, or Co- 
lumbo in their usual doses, are proper. 

A glass of brandy, at bed-time will generally prevent the attack. 

Prevention. — The patient should sleep on a hard bed, which 
invites to frequent changes of sides, eat light suppers, which, with 
due exercise, and cheerfulness during the day, form the best preven- 
tive remedies. 

38 



29S ASTHMA. 



ASTHMA 

Is often hereditary. When attended with an expectoration of 
phlegm, it is termed moist or humeral ; and when with little or 
none, dry or nervous asthma. 

Symptoms. — It generally attacks at night with a sense of tightness 
across the breast, and impeded respiration. The person thus taken, 
if in a horizontal situation, is obliged immediately to get into an 
erect posture, and solicits a free and cold air. In violent paroxysms, 
speaking is difficult and uneasy. 

Treatment. — On i\\z first attack of asthma, bleeding is service- 
able, if the pain in the chest and difficulty of breathing be consider- 
able ; but less so afterwards, since the disease has a natural tendency 
to take off the plethoric state of the system. 

Emetics frequently repeated have been found of considerable 
utility in this disease. When there is reason to apprehend a paroxysm 
in the course of the night, an emetic exhibited in the evening will 
generally prevent it; and when the fit comes on in consequence of 
a loaded stomach, it will often afford immediate relief. 

As in other spasmodic affections, the most powerful antispasmodics, 
as laudanum, and ether, should be resorted to. These may be given 
conjointly or separately, but in large doses, to allay the violence of 
the fit, or to prevent its accession. Thus, half a tea-spoonful of 
laudanum, or one of ether, to be repeated in an hour, if necessary, 
in a glass of cold water, has frequently relieved the symptoms, or, 
when taken at the approach of the fit, have suppressed it altogether. 
A cup of strong colfee has sometimes afforded great relief; and when 
the disease proceeds from the irritation of mucus, a table-spoonful or 
two of vinegar in a glass of cold water is a good remedy. 

The skunk cabbage and stramonium, or thorn apple, are considered 
most valuable antispasmodics, and exceedingly beneficial in this 
complaint. According to Dr. Cutler, the emetic weed or Indian 
tobacco, {see Materia Medical) is a certain remedy. And Dr. 
Thomas speaks highly of the efficacy of the tincture of foxglove, in 
doses of fifteen drops twice a-day, conjoined with a few drops of 
laudanum. 

In every stage of this disease, the bowels must be attended to. 
The connexion of asthmatic paroxysm, with tlatulence and coslive- 
ness, plainly points out the importance of aperient medicines and 
those of the warm class, as aloes and rhubarb. 

Expectorants are frequently required in this disease. The powder, 
or syrup of squills, or gum-ammoniac exhibited in rather larger doses 
than usual, will often bring on expectoration, in cases apparently 
desperate. 

Blisters near the back are singularly useful, and should be often 
repeated. Cataplasms of garlic or onions to the feet are also valuable 
assistants. 



HEART-BURN 299 

Regimen. — A light diet, easily digestible, and not flatulent, is 
always proper for asthmatic persons, and during the fit, cool drinks 
and fresh air are proper. It will always be found serviceable to wear 
a flannel shirt and to keep the feet warm. 

Prevention. — During the absence of the paroxysm, tonic medi- 
cines and the cold bath, together with moderate exercise, will be 
most efficacious in obviating its recurrence. 



HEART-BURN. 



Symptoms. — A burning sensation about the pit of the stomach, 
with acid eructations, flatulence, and sometimes retching to vomit. 

Causes. — A relaxed state of the stomach, generating acidities and 
acrimonies from food too long detained. As it is often a symptom 
of indigestion, the cause may be found under the head of the follow- 
ing chapter. 

Treatment. — The first indication is to remove the unpleasant 
sensations existing, which may be done by taking either a small tea- 
spoonful of salt of tartar, or a table- spoonful of magnesia in a glass 
of mint-water or tea ; or a tumbler of mucilage of gum Arabic or 
flax seed tea taken cold, with a small piece of liquorice ball dissolved 
in it. But, to cure the disease effectually, after an emetic, give the 
lime-water, or ten grains of the rust of steel, thrice a-day for some 
time, and keep the bowels moderately open with magnesia or the 
root of rhubarb chewed occasionally, or the tincture of it, taken in 
small doses; or the aloetic pill. 

If it should arise from bile, lemonade, or some of the vegetable 
acids, or a tea-spoonful of the spirits of nitre in a glass of the infusion 
of Columbo, will often afford immediate relief. 

When not arising from the contents of the stomach, general 
warmth, particularly of the feet, is essentially useful ; and even rub- 
bing them with flour of mustard, or tincture of Cayenne pepper, has 
produced good effects. Great benefit has also been experienced, and 
sometimes a complete cure effected, by the application of a blister to 
the pit of the stomach. To render it more efficacious, the blister 
should be kept running for at least a week. 

Regimen. — The diet of those who are subject to this complaint, 
should consist chiefly of animal food ; and all fermented or acid 
liquors and greasy aliment must be strictly avoided. A glass of 
brandy, or gin and water after dinner, is the best beverage* Moderate 
exercise is oarticularlv beneficial. 



300 



OR INDIGESTION. 



DYSPEPSIA, OR INDIGESTION 

Symptoms. — Want of appetite ; nausea ; sometimes vomiting ; 
heart-burn; costiveness; distentions of the stomach, particularly upon 
taking a small quantity of food ; frequent risings into the throat of 
a sharp acid liquor, and eructations of imperfectly digested matter. 

Causes. — Errors and irregularities in the mode of living; cola 
and moisture; intense study; depressing passions; and abuse of 
tobacco, opium, or spirits. 

Treatment. — To succeed in the cure of this disease, we must 
avoid the occasional causes, remove such symptoms as tend to aggra- 
vate or continue the disease, and invigorate the tone of the stomach. 
Crudities, acidity and costiveness, must be obviated, at least in their 
excess, as they tend both to aggravate and continue indigestion. 
The management of diet is also of considerable importance. The 
stomach should never be suffered to remain any time empty in dys- 
pepsia, as all the symptoms are aggravated by it. Persons afflicted 
with this complaint, should frequently eat a cracker or a piece of ship 
biscuit, as bread not subject to fermentation is one of the best sub- 
stances to be frequently taken. In some weak stomachs, a singular 
aggravation of the symptoms comes on in about an hour or two after 
a full meal, attended with a sense of sinking or weakness. This 
seems to be owing to a digestion unusually rapid, and consequently 
imperfect. In such cases, aliment of more difficult digestion, as eggs 
boiled hard, or the addition of condiments which retard digestion 
may be allowed; but, in general, a bit of biscuit and a glass of wine 
will remove the sense of weakness, which is owing to the sudden 
emptying of the stomach before too much distended. 

In order to the cure, recourse must be had to emetics, whenever 
the stomach is offended with mucus, bilious, or other humours. It 
is not unusual for a large quantity of very viscid mucus to be thrown 
up on the exhibition of an emetic. And this must occasionally be 
discharged, and its accumulation prevented by aromatics and tonics. 

The Columbo root is a medicine of great utility, when the stomach 
is languid, and the appetite defective. It may be given thrice a-day, 
in substance or infusion, with mint-water, or ginger tea, or infused 
in Madeira wine, or French brandy, now and then interposing small 
doses of the tincture of rhubarb. Taking a tea-spoonful of mustard 
seed with half the quantity of Columbo thrice a-day, will be found 
particularly useful, where acidity and flatulence prevail. A great 
variety of stomachics and tonics of the vegetable class, as camomile, 
gentian, quassia, Peruvian, and black oak bark, have been employed 
in the cure of this disease ; but scarcely any merits a preference 
to the Columbo, unless the Samson snake-root. (See Materia 
Medica.) However, it is not proper to continue the use of any tonic 



DYSPEPSIA, OR INDIGESTION. 301 

longer than two weeks at a time. When acidity predominates, a 
wine-glass of lime-water, with an equal quantity of new milk, or ten 
grains of rust of steel, or filings of iron, will be found exceedingly 
beneficial. 

In some cases the digestion is injured by putrid matter, from 
decayed teeth, constantly mixed with the saliva, affecting the organs 
of taste, and destroying the appetite. In such cases, the charcoal 
tooth powder, (see Dispensatory^) or washing the mouth night 
and morning with the solution of alum, will correct this tendency. 
Even when the teeth could not be the cause of indigestion, I 
have seen the most happy effects result from the exhibition of char- 
coal powder, in doses of a table-spoonful, twice or thrice a-day, 
particularly when conjoined with a few grains of rhubarb, and 
double the quantity of powdered ginger, or by taking, after dinner, 
as much of the tincture of rhubarb as would keep the bowels in a 
regular state. Another medicine, apparently simple, though of con- 
siderable efficacy in this complaint, is the cob-web of the black 
spider, which generally inhabits the cellars, barns, and stables. Of 
this, from five to ten grains is to be given morning, noon, and night, 
in the form of pills. 

If the disease, as is too often the case, have been brought on by 
hard drinking, its only radical cure is to be found in temperance, 
cordial nourishment, exercise, and the use of elixir vitriol with bark, 
the nitric acid or the tonic powders or pills, (see Dispensatory.) 

When the patient complains of a pain in the stomach, resort to 
the remedies for heart-burn, and use friction with a flesh brush or 
flannel over the part. Should this fail, give a dose of ether or lau- 
danum ; and, in case of costiveness, administer an injection. This 
treatment will generally palliate the pain ; after which, endeavour to 
restore the tone of the stomach by tonic medicines, as the nitric acid, 
bark, Columbo, steel, &c. 

The costiveness peculiar to persons in this complaint, must be 
removed by medicines which gently solicit the intestines to a more 
regular discharge of their contents ; and this effect is best obtained 
by flour of sulphur, magnesia, or rhubarb chewed every day, and 
only the saliva swallowed. Strong purgatives are unfit to correct 
habits of costiveness, as they weaken the action of the intestines, and 
thereby increase the complaint when the evacuation is over. 

But nothing can so effectually obviate this affection, as the con- 
stant custom, most invariably observed, of going every morning to 
the privyj although you have not a natural inclination. 

Regimen. — The diet should consist chiefly of animal food well 
chewed, and taken in small quantities, followed with a glass of 
brandy and water, or good wine. Frequent friction with a flesh 
brush or flannel over the region of the stomach and belly will be 
found exceedingly beneficial. 

After taking an emetic, we have known a milk diet, persevered 
in for several weeks, effectually cure indigestion. This article, 



502 



COLIC. 



almost always offends the stomach at first ; but by continuance, be- 
comes agreeable to it, and effects a cure. The milk should be new, 
and free from acidity. 

Early rising, and moderate exercise in the morning air, can hardly 
be enough recommended, inasmuch as they contribute so happily to 
restore the tone of the stomach, as also the whole system. 

It is impossible to furnish a plan of regimen adapted to eveiy con- 
stitution and habit ; but if the patient will but pay due attention to 
what benefits, and what injures him, wisely regulating his mode of 
living by the information thus obtained, his present maladies will 
soon disappear, and their future recurrence for ever inhibited. 



COLIC. 

Symptoms. — A violent pain in the bowels originating from con- 
striction, attended with costiveness, and sometimes vomiting. The 
pain is commonly seated about the navel, and resembles various 
sensations, as of burning, twisting, boring, or a ligature drawn very 
tight across the intestines. 

It comes on without fever, which soon follows, especially if inflam- 
mation take place in the intestine affected, and then all the symp- 
toms become greatly aggravated. 

Causes. — Flatulency; indigestible aliment taken into the sto- 
mach ; acrid bile ; hardened faeces ; costiveness ; worms ; drinking too 
freely of acids; intermittents improperly cured; sudden check of 
perspiration ; and the application of poisons, such as lead, &c. (fee. 

Treatment. — When the disease evidently arises from wind, 
which may be known by a rumbling in the bowels, by pressure on 
the belly, or by the ease experienced from a discharge of it, or by the 
patient's lying on the belly, a glass of brandy, gin, strong mint-wa- 
ter, or tea made of ginger or calamus, will generally give relief : but 
it is only in colic from wind that these hot, spirituous and carmina- 
tive substances are to be used ; for in all other cases they do great 
harm, and often destroy life. The flatulent colic is frequently caused 
by wetting the feet, or otherwise checking the perspiration. — When 
this is the case, rubbing the legs and arms with warm cloths, and 
afterwards keeping the feet for some time in warm water, will be the 
most effectual remedy. 

As a spasm is the immediate cause, its resolution is the chief indi- 
cation of cure ; for this purpose relaxing and antispasmodic medicines 
with purges, which, while they solicit the internal discharge, will not 
greatly increase the morbid irritation, are the most proper means. 



colic. 3o3 

Where the pain is fixed and acute, bleeding is advisable, particu- 
larly in full habits, to prevent inflammation. Next, the action of the 
intestines must be excited by brisk purgatives, such as castor oil, 
calomel and jalap, or salts, senna and manna, aided by stimulating 
clysters. The castor oil is often an invaluable medicine in this dis- 
ease. From one to two or three drops, will often succeed in purging 
the bowels, where all other remedies have failed. (See Dispensa- 
tory.) If these means prove inefficacious, immediate recourse must 
be had to the warm bath, in which the patient should remain as long 
as he can bear it. Where a bathing vessel cannot be procured, flan- 
nels wrung out of hot water, should be frequently applied over the 
belly as warm as can be endured. Besides which, tobacco clysters, 
(see Materia Medical) ought to be administered ; and when the pain 
continues obstinate, apply a large blister over the belly. 

If the above remedies prove ineffectual, opium and calomel, in 
large doses, should be employed. To their exceeding utility in ob- 
stinate colic, I can subscribe from numberless successful experiments 
made by myself. * 

Eminent modern physicians advise, that when all other means are 
despaired of, the patient should be placed erect on the floor, and a 
pail of cold water thrown on his feet and legs ; this, though appa- 
rently a droll remedy, yet certainly deserves to be tried in desperate 
cases, especially as we are assured, from the best authority, that it 
has often succeeded : it acts, as it is said, by occasioning an imme- 
diate evacuation of the bowels. 

For the vomiting which often occurs in this disease, common gar- 
den mint, peppermint, (see Materia Medica,) or any other spices 

* How I came in possession of this admirable secret, both justice and grati- 
tude require that I should explain. 

In the year 1801, I spent several weeks in Georgetown, Columbia District. 
While there, I was requested to visit a Mr. James Turner, who had long been 
indisposed with the ague and fever ; but then suffering under a severe attack 
of the colic, accompanied with most obstinate costiveness. For two or three 
days the best aperients, as calomel, castor oil, salts, senna and manna, and in- 
jections, with the warm bath, and blisters, were used but without effect. 
Being much alarmed about his situation, I stated the case to my very excellent 
friend, the ingenious and learned Doctor John Weems, who advised the imme- 
diate use of six grains of opium, with twenty of calomel, in a bolus, and one- 
third of that dose every two hours afterwards, if the first failed to operate. I 
expressed my fears that so large a dose of opium might do harm. " No, sir," 
replied he, " 'tis small doses that do harm ; give large doses, large enough to 
take off the spasms, and you save the patient." 

I still retained my repugnance ; however, recollecting his great medical at- 
tainments, and the desperate case of my patient, I acceded to his advice, and 
scarcely was the second dose swallowed, before it began to operate like a 
charm. The spasm was taken off the intestines; copious fetid evacuations 
succeeded, and our patient was presently restored. 

This is but one of many extraordinary cures performed by Doctor John 
Weems. The citizens of Georgetown and Washington, will long lament the 
early fate of this gentleman, of whom for ardent friendship, and medica] saga- 
city, I can truly say — his equal I have seldom seen, his superior never. 



304 CHOLERA MORBUS. 

boiled in spirits, and flannels wrung out of it, and laid hot on the 
pit of the stomach, are excellent, especially if a little laudanum be 
added. If acrid bile be thrown up, the saline mixture, or infusion 
of Columbo should be given ; and when vomiting is attended with 
cold extremities, warm applications to the feet, and a blister to the 
back, often relieve the symptom. It is also frequently removed by 
a blister on the pit of the stomach. 

In violent colics, attended with vomiting, it is always advisable to 
administer an anodyne injection, and if it be speedily discharged, the 
clyster should be repeated till the vomiting ceases. A dose of calo- 
mel and jalap, castor oil, or infusion of salts, senna and manna, is 
then to be administered every two or three hours, until evacuations 
are procured. 

Regimen. — Evacuations being once procured, mucilaginous 
drinks and light diet should be strictly adhered to, and the bowels 
kept moderately open by mild purgatives, giving opiates at bed-time, 
if necessary, until the soreness and distention of the belly go off, and 
no hardened faeces appear in the stool. 

Prevention. — Those who are at times afflicted with pains in the 
belly should keep the feet dry and warm ; abstain from flatulent 
food, and attend carefully to the bowels, to prevent constipation. 
Those whose occupation subjects them to the fumes of lead, should 
breakfast on fat broth before they begin their work, and frequently 
interpose oily purgatives. 



CHOLERA MORBUS, 

OR VOMITING AND PURGING. 

Causes. — It is generally occasioned by a redundancy and acri- 
mony of the bile ; indigestible food, or such as becomes rancid or 
acid on the stomach ; poisons ; strong acrid purges or vomits ; pas- 
sions of the mind, or a sudden check of perspiration. 

Treatment. — Endeavour, as early as possible, to expel the acri- 
monious matter which affects the alimentary canal, by large and re- 
peated draughts of chicken-water, beef tea, barley or rice-water, or 
thin gruel, &c, which should also be given freely in clysters. It is 
said, upon high authority, that frequent small doses of cold water, 
not exceeding a gill at a time, will check the purging, cool the ar- 
dent heat of the stomach, and abate the thirst. Cold water is the 
more efficacious as the climate, season, and constitution of the pa- 
tient are warm ; for it cools, blunts acrimony, and restores the tone 
of the parts. It should be repeated as often as the patient throws up 



EPIDEMIC, OR MALIGNANT CHOLERA. 305 

what he drinks ; and if fainting, with other symptoms of weakness 
come on, a little wine should be added to each draught of water. 
After having cleansed the stomach and intestines, give a tea-spoonful 
of ether, or thirty or forty drops of laudanum, in mint- water or tea, 
and repeat the dose every hour, or oftener, as the frequency of the 
evacuations or the urgency of the pain may require. 

If the laudanum be rejected from the stomach, give a tea-spoonful 
of paregoric, or opium in pills of half a grain, repeated every half 
hour at the farthest, until the disease be checked ; and at the same 
time, apply mint leaves stewed in spirits to the pit of the stomach. 

In general, this mode of treatment is sufficient ; but if the patient 
be of a plethoric habit, he ought to lose blood immediately ; and, in 
case the pain continue violent, be placed in the warm bath. Should 
the bathing vessel not be at hand, peppermint stewed in spirits, or 
cloths wrung out of hot spirits or decoction of camomile, hops or la- 
vender, ought to be applied to the stomach and belly, and often 
renewed. 

If acrid bile be the cause of this complaint, the Col umbo must 
be given every hour, or oftener, in large doses ; and, in case of great 
heat, a small quantity of nitre in the patient's drink, will be proper. 
In warm climates this remedy is considered almost a specific; it soon 
abates the violent evacuations, and, by continuing it a few days, a 
cure is effected. A tea-spoonful of the Columbo, finely powdered 
in a glass of mint-water or a gill of the infusion may be repeated 
every hour or two, according to the urgency of the symptoms. In 
preparing the infusion, it is better to add one-fourth vinegar, or some 
grateful aromatic, in cases unattended with fever. 

When the disease originates from food, either very acid or putrid, 
besides plentiful dilution with the above drinks, give castor oil, salts, 
or rhubarb; and if from poisons swallowed, the patient should drink 
largely of pure sweet oil, melted butter, or mucilaginous drinks, with 
small portions of salt of tartar. 

Regimen. — As no disease more suddenly weakens the patient, he 
should take freely of a light but cordial and nourishing diet, occa- 
sionally assisting his appetite, if deficient, with elixir vitriol, tincture 
of bark, or infusion of Columbo. If he cannot sleep well, an opiate 
at bed-time may be taken until his strength and spirits return. 



EPIDEMIC, 

OR MALIGNANT CHOLERA. 

Causes. — The general or remote causes of this, as of all other 
epidemics, is some atmospheric influence, the nature of which is 
veiled in darkness. The exciting causes are imprudence in diet, as 
39 



306 EPIDEMIC, OR MALIGNANT CHOLERA. 

eating unripe fruit, imperfectly cooked vegetables, tainted provisions, 
of any kind, gross animal food, shell-fish, or immoderate quantities 
of even the most innocent food. Intemperance in drink is a frequent, 
cause, and one which materially lessens the chance of recovery. 
Exposure to the night air, unusual fatigue of body or mind, the de- 
pressing influence of fear, any material deviation from accustomed 
modes of living, in fact, every thing that tends to depress the powers 
of life below the standard of health will, during the prevalence of 
the disease, act as an exciting cause. Tampering with medicines, 
particularly emetics and cathartics, to ward off the disease, has, in 
numberless cases, been the cause of an attack. 

Contagion has been alleged as a cause, but without the shadow 
of a solid foundation ; on the contrary, the strongest reasons can be 
given to prove, that the disease is not, under any circumstances, 
taken, by one person, from another. The attempt, therefore, to 
keep off the disease, by cutting off communication with an infected 
district, or by refusing aid to the unfortunate sufferers, is not only a 
shocking breach of moral law, but of common sense. No — the 
cause of the disease is in the air we breathe, and every act of inspi- 
ration, and every act of swallowing increases the quantity of the 
poison in our system. Our safety, therefore, depends on prudence, 
alone, which requires strict attention to the means of prevention and 
avoidance of the exciting causes. These views I conscientiously 
advance, with a firm conviction of their truth : and with feelings 
alive to the responsibility. 

The Symptoms vary very much in different cases, the variation 
being occasioned by the exciting causes and by the peculiar condition 
of the patient's system at the time of attack. In a vast majority of 
cases, however, the disease presents a uniformity of symptoms rarely 
to be met with in an epidemic. This disease is evidently a modified 
form of the common cholera morbus, of our country, being highly 
aggravated and rendered far more malignant, by the atmospheric 
influence mentioned above, which is the cause of its becoming epi- 
demic. In this, cholera agrees with dysentery, scarlet fever, and 
every other disease, that ever becomes epidemic; for it is a fact well 
known, that, those diseases are far more malignant when they prevail 
epidemically than when occasional cases only occur. 

In a majority of cases the individual is warned of approaching 
danger, by what are called the " premonitory symptoms." These 
are furred tongue, frequent pains in the stomach and head, and 
watery discharges from the bowels. During the prevalence of the 
epidemic, few persons in the infected district escape without ex- 
periencing some of these symptoms, particularly the pains in the 
stomach , which appear to be excited by food which had never, be- 
fore, disagreed with the individual. The duration of this stage of 
the disease is uncertain ; in many instances it will continue for days, 
and if the patient be prudent, it will in some cases go off even with- 
out medicine, the system, probably, gradually becoming accustomed 



EPIDEMIC, OR MALIGNANT CHOLERA. 307 

to the atmospheric poison which is the cause of the disease. In other 
cases the disease advances, the discharges from the bowels become 
increased in frequency and in quantity, and the disease hurries with 
greater or less rapidity into the second stage, or what may be termed 
confirmed cholera, when some additional symptoms present them- 
selves. In addition to the copious and frequent discharges of a fluid 
resembling rice-water, in which are floating numerous white flakes, 
the patient now complains of oppression and sickness at the stomach, 
with heart-burn ; vomiting now takes place, at first of the common 
contents of the stomach, which are soon followed by the same kind 
of fluid which passes from the bowels ; cramps now come on, affect- 
ing at first the feet and hands, but rapidly extending, they, by turns, 
affect all the muscles of the body, and in some cases every joint, at 
the same instant, is rendered immoveable. The stomach, in some 
cases, is also violently cramped. The muscles of the face are some- 
times affected, producing great distortion of the countenance, which 
contributes not a little, to heighten a scene of horror, which it is as 
impossible to describe as to forget. The skin is now bathed in a 
cold sweat, which produces a wrinkled appearance of the fingers re- 
sembling those of a person whose hands have been long immersed 
in water; it is also, as cold or more so, than that of a corpse, particu- 
larly over the limbs. Respiration is laborious, and the air expired is 
cold or nearly so. The tongue is cold and moist ; notwithstanding 
which, the patient complains of an unquenchable thirst, and exces- 
sive burning in the stomach, which neither water nor ice can relieve. 
The countenance is indicative of the greatest distress and anxiety;— 
the mind is unimpaired ; — the blood, if now examined, is thick and 
black, and resembles tar more than any thing else to which it could 
be compared ; — the pulse, which at first was slow, contracted and 
somewhat tense, now becomes more hurried, smaller and weaker. 

If the disease be not now arrested, the patient soon sinks into the 
third stage, called " collapse." In this stage the disease continues 
to advance with the same train of symptoms, each moment making 
it more evident that the work of death is fast drawing to a close. 
The blood continues to recede from the surface, the eyes sink in 
their sockets and are surrounded by a blue or leaden hue — the skin 
over other parts of the body assumes the same colour, particularly 
about the hands and feet — the lips lose their colour, even the inner 
surface of the lips and cheeks and also the tongue are forsaken by 
the blood, and become pale and cold. The pulse continues to sink 
until it is no longer perceptible ; even the heart itself can scarcely 
make us sensible of its motion. The patient now appears indifferent 
about his situation — he seems to think or care, neither for himself 
nor for others, though his mind may retain its faculties to the last. 
The skin is now universally cold, and still bathed in perspiration, 
yet even under these circumstances its sensibility is sometimes so 
great, that the patient cannot bear the warm applications made use 
of to support him, nor can he even bear, patiently, the warmth of a 



308 EPIDEMIC, OE MALIGNANT CHOLERA. 

single blanket. In other cases, the skin appears devoid of sensibility, 
the most stimulating articles produce no effect. In some cases, the 
vomiting and purging continue to the last, and the cramps have been 
known to continue for many minutes, and even hours, after every 
other appearance of life had ceased. In other cases, the primary 
and most important symptoms, as, vomiting, purging, and the cramps, 
now take their leave after having forced their victim beyond the 
reach of nature and of art. If the disease be not arrested, the pa- 
tient either sinks quietly into the anus of death without a struggle or 
a pang; or, as is often the case, he leaves the world in a paroxysm 
of agony, his limbs being distorted into every possible shape by the 
violence of the cramps. 

If, however, nature and art should triumph over this terrible min- 
ister of death, the first change we should look for, is the appearance 
of bile in the passages from the bowels. When we see this sign we 
may safely pronounce the patient out of danger ; for I never saw or 
heard of a death from this disease after the return of the secretion 
of bile. I hail the appearance of bile as a harbinger of returning 
health ; for, as if by magic, the symptoms of the disease disappear ; 
urine, the secretion of which, like that of the bile, had been entirely 
suppressed, now begins to flow ; the discharge from the skin ceases, 
the blood returns to the lately deserted surface, and with it, vital 
heat, and the patient, after copious discharges of bile for two or 
three days, rapidly returns to health. These are symptoms of a 
healthful reaction. 

There are some cases of reaction which would deceive the inex- 
perienced, and excite hopes of recovery which would never be rea- 
lized. In these cases, the patient, after remaining from a few hours 
to two or three days, will exhibit signs of amendment; he may be 
free from cramps, from vomiting, and from purging ; his pulse may 
rise, his skin become dry and warm, yet the secretions are not re- 
stored. These cas^s terminate fatally in a few hours after the ap- 
parent improvement, — nature, in her last effort, producing an ex- 
citement which may well be compared to the glare of an expiring 
taper. No reaction can be depended on which is not based on a re- 
storation of the secretions. 

The above are the symptoms of cholera as it generally appears. 
The varieties I will cursorily notice. In some cases the patient has 
no premonitory symptoms, but is taken suddenly, after eating some 
improper food, with a sense of weight and sickness at the stomach. 
Vomiting speedily supervenes, and is succeeded at first by discharges 
of the ordinary contents of the bowels, which are soon followed by 
the peculiar discharge; the other symptoms rapidly chime in, and 
the disease proceeds as above described. Some cases are not at- 
tended with cramps, the vomiting and purging being the principal 
symptoms. Other cases, again, are not attended with vomiting and 
purging, the cramps being the most striking symptoms. The cramps 
in these cases are more violent than in the cases which are attended 
with copious vomiting and purging. 



EPIDEMIC, OR MALIGNANT CHOLERA. 309 

Treatment. — The first stage, commonly called " The premo- 
nitory symptoms," is, in a vast majority of cases, easily managed, 
and often goes off without any treatment. No one should, however, 
presume on this, for a slight cause may hurry on the disease, and 
before the remedies could produce their effects, he may be in eter- 
nity. Prudence, therefore, dictates that, immediately upon the ap- 
pearance of the diarrhoea, something should be done to remove it. 
To effect this, a variety of articles are extolled as specifics ; such as 
the spirits of camphor, essence or oil of peppermint, laudanum, and 
other articles possessing similar properties. That these articles some- 
times succeed we have no doubt ; that they often fail, almost every 
case of cholera proves ; for it is rarely we meet with a confirmed case 
of this disease, in which they had not previously received a fair trial. 
We should bear in mind that the discharge from the bowels is not 
the disease itself, but an effect of the disease, which is some consid- 
erable disturbance of the system. If, therefore, we should check the 
effect without removing the disease, we should, in many cases, act 
as unwisely as the man who would lock up a thief in his house and 
leave him to do what mischief he pleased. We should attack the 
disease itself, with our most powerful means. — Of these, we will 
always find calomel to be the most certain ; and should, therefore, 
give it immediately, either in a full dose of twenty grains at once, or 
in five grain doses every hour, until twenty grains have been taken ; 
and, in either case, follow it up with a full dose of rhubarb, or castor 
oil, to either of which three or four drops of the oil of cinnamon may 
be added. These medicines must be repeated until the discharges 
become natural. 

In some cases where there is much uneasiness in the stomach and 
head, and the pulse is slow andgfull, blood-letting is advisable, and 
may be necessary. 

These means will almost invariably remove the premonitory 
symptoms, or what we will call the first or forming stage of cholera, 
and the patient returns to health. 

In the second stage, or confirmed cholera, we have many indica- 
tions to fulfil, the leading one of which is to restore the secretions, 
and particularly that of the bile. This, possibly, we could not ac- 
complish without fulfilling another important indication, which, is 
to relieve the congestion of the internal organs, by bringing the blood 
to the surface. While directing all our energies to the accomplish- 
ment of these objects, we should not neglect two other important in- 
dications, which are, to check the discharges and relieve the spasms 
or cramps. 

The first step in the treatment of this stage is to relieve the stomach 
of any indigestible food, which it may contain. For this purpose 
various emetics have been extolled as possessing superior claims to 
confidence; as the white vitriol, ipecacuanha, tartar emetic, an infu- 
sion of mustard and salt in water. Of these, ipecacuanha is to be 
preferred, and should be given in a dose of twenty-five or thirty 



310 EPIDEMIC, OR MALIGNANT CHOLERA. 

grains. If this cannot be obtained, the white vitriol may be taken 
to the same extent. The mustard or tartar emetic I could not re- 
commend. If the stomach have been evacuated by spontaneous 
vomiting, an emetic should not be given, for, to say the least, it 
would be a waste of time. The stomach being prepared, from 
twenty to thirty grains of calomel, to which may be added one or 
two drops of the oil of cinnamon, must be immediately given, and 
repeated every hour or oftener, if the symptoms be urgent, until bile 
appear in the discharges. The calomel had better be taken in syrup, 
that it may act without delay. 

As a means for relieving congestion and overcoming the cramps, 
blood-letting stands pre-eminent. It should be had recourse to, 
without delay, notwithstanding, the great apparent debility. The 
blood is now black, and in some instances so thick that it will not 
flow unless forced from the orifice by rubbing the vein : if, however, 
this be persevered in for a few minutes, it becomes thin, and soon 
runs in a free stream. The quantity of blood to be taken depends 
on the constitution, &c, of the patient. From a robust man from 
one to two pints may be taken with advantage. In more delicate 
patients the quantity must be less. The local detraction of blood, 
by cupping or leeching, has been recommended, but as it is less 
efficacious than general bleeding, it need not be resorted to, when 
the latter is practicable; — besides, the unavoidable delay is an insu- 
perable objection, for in this disease the loss of a few moments may 
be the loss of the patient. I cannot leave the consideration of this 
remedy, blood-letting, without insisting on its employment, and re- 
peating that it is one of the most powerful means we possess, for 
overcoming the spasms, removing congestion, and thereby contribu- 
ting, to arrest the morbid discharges and to promote the healthy se- 
cretions — thus powerfully aiding in the fulfilment of the four impor- 
tant indications mentioned above. In addition to the powerful re- 
medies just recommended, there are many others which we may 
have recourse to, not only with the view of aiding the former, but 
also to fulfil some other indication. Thus, to aid in bringing back 
the blood to the surface and to relieve the cramps, we must make 
use of external stimulants, of these, dry heat is the first that sug- 
gests itself. This may be applied, by means of jugs or bottles of 
hot water, to the extremities, and particularly to the muscles affected 
with cramps. Frictions, either with a stiff brush or with a warm 
coarse cloth, are valuable. They should be perseveringly used, and 
directed principally along the course of the contracted muscles. To 
increase the efficacy of the frictions, the brush or cloth may be 
dipped in some stimulating substance, such as spirits of turpentine, 
infusion of red pepper in whiskey, a strong ointment made of hog's 
lard and red pepper, or the powder of red pepper may be used in its 
dry state, and an ointment made of hog's lard and powdered cam- 
phor ; but, what is probably better than all, is a strong mercurial 
ointment, made irritating by the addition of powder of red pepper or 
camphor. 



EPIDEMIC, OR MALIGNANT CHOLERA. 311 

The excessive thirst and burning at the stomach render some 
kind of drink absolutely necessary. The best drink is water, as 
cold as it can be obtained. It should, however, be taken in modera- 
tion. One or two table-spoons full every five or ten minutes will be 
sufficient, or a small piece of ice may be allowed to dissolve in the 
mouth. 

I have now, in as concise a manner as possible, given the practice, 
which I have found successful in a large majority of cases, and 
which will suit the various forms of the disease in this stage. There 
is, however, one form of the disease in which a modification of the 
treatment may be necessary. This is the form, noticed under the 
head of symptoms, in which there is little or no discharge from the 
bowels or stomach, but universal spasms of the whole muscular sys- 
tem, affecting also the stomach, and in some cases even the muscles 
of the tongue. In this form of the disease, if we suspect the sto- 
mach contains any kind of food, we should immediately exhibit 
twenty-five or thirty grains of ipecacuanha, in a tea-cup full of warm 
water; and, without waiting for its effects, tie up the arm and bleed 
until a decided effect is produced on the pulse. At the same time, 
frictions over the seat of the cramps, with some of the irritating arti- 
cles, advised above, should be diligently employed. Should these 
means fail to arrest the cramps, we should, after the operation of the 
emetic, give laudanum in a dose of from one to two or three tea- 
spoons full, according to the urgency of the spasms ; and if necessary, 
give a tea spoonful every half hour, continuing the frictions, until 
relief is obtained. If nothing occur to prevent it, the patient may 
be suffered to rest for some hours, after which he should take from 
twenty to forty grains of calomel, which should be followed by the 
same quantity of rhubarb, or by two or three drops of Croton oil. 

Before leaving the consideration of this, the second stage of cholera, 
it wilt be proper to notice some of the articles which have been ex- 
tolled in the treatment of the disease. Opium either in substance, 
or in the form of laudanum, has been extensively employed, and in 
every variety of dose, from the smallest to the most enormous. My 
opinion of this article is, that it is inadmissible in every form of this 
disease, with the exception of that variety of it, which has just been 
treated of. If taken in sufficient quantity to produce any effect, it 
retards the operation of the calomel, and thereby lessens the chance 
of the patient's recovery, for on the speedy operation of the calomel 
his safety depends. Another article, which has been highly spoken 
of, is the mustard emetic. Against this article, as an internal 
remedy, I protest: it has, however, been as extensively used as the 
opium, and I will say, with as little regard to consistency, for many 
physicians, who condemn the internal use of stimulants in this stage, 
make it a general rule to administer this article in every case, know- 
ing at the same time that it is so highly irritating, that it cannot he 
endured more than a few minutes on the most insensible parts of the 
skin. The indiscriminate use of emetics, of any kind, is improper. 



312 EPIDEMIC, OR MALIGNANT CHOLERA. 

Where vomiting has not taken place, it will generally be advisable 
to give an emetic of the mildest kind, as ipecacuanha ; but where 
spontaneous vomiting has come on, an emetic will be of no use, but 
will cause the loss of precious time. Camphor is another article, 
which attracted much of the public attention. As it is a stimulant, 
its use cannot be justified in this stage. The limits and object of 
this work will not admit of a detail of reasons for the support of 
opinions: I shall therefore pass on to the treatment of the third or 
collapsed stage of cholera. If the disease be not arrested by the 
means which have been detailed, it gradually passes into the collapse, 
and we have a different state of symptoms, which have been de- 
scribed under the proper head. We must still continue the calomel, 
and aid it in its alterative effects by the steady use of the irritating 
mercurial ointment formerly advised. If nothing has been done for 
the patient until now, blood should be drawn, if possible, either in 
the common way or by cupping. Blood-letting, in this disease, is 
not employed to reduce the system, but to relieve congestion, and 
thereby prove an indirect stimulant. We are now obliged to make 
use of direct stimulants. The external stimulants, as heat, frictions, 
and irritating applications, must be continued. Large mustard plas- 
ters should be applied, and moved from place to place as the patient 
complains of their producing pain. Plasters of blistering ointment 
should be applied, and if they draw, the sore should be dressed with 
mercurial ointment. Internal stimulants must now be given. As 
spirituous liquors could not be borne, we must have recourse to the 
vegetable spices, as cloves, ginger, Cayenne pepper, or oil of cinna- 
mon. A table -spoonful of a strong infusion of cloves or ginger, or 
two or three drops of the oil of cinnamon, may be given every half 
hour. The following preparation is highly recommended : Take 
of Cayenne pepper three table-spoons full, of fine salt two tea-spoons 
full, beat them well together, and then pour, on the mixture, half a 
pint of boiling water ; when cold, strain off the infusion and add an 
equal quantity of strong vinegar. The dose is a table-spoon full 
every half hour. 

Having by these means succeeded in arresting the disease, which 
we are assured of by the reappearance of the secretions, and other 
changes mentioned under the head of symptoms, we must take care 
that the reaction does not exceed the bounds of health. In most 
cases nothing is necessary but a light and nourishing diet, warm 
clothing, an occasional use of small doses of rhubarb, either alone 
or combined with magnesia, and mild tonics, as infusions of Columbo 
or camomile. In some cases, however, reaction may be followed by 
fever. In this case, if the pulse be full or strong, we must bleed and 
resort again to cathartics. If, on the contrary, the pulse be small 
and weak and the symptoms resemble those of typhus fever, the 
remedies directed for that fever must be used. In some cases reac- 
tion is followed by determination of blood to the brain, or some other 
important organ. These cases must be treated by local bleeding, 



DIARRHCEA, OR LOOSENESS. 313 

by cups or leeches, over the affected organ, by the use of calomel, 
unless the system be already affected by it, and other cathartics ; and 
by frictions, with irritating applications to the extremities. If it be 
(lie brain that is affected, cold applied to the head will be servicea- 
ble. The diet should be light. 

Prevention. — An old adage says, " An ounce of prevention is 
worth a pound of cure." In this disease it is worth tons. On the 
appearance of the epidemic in a neighbourhood, the strictest attention 
should be paid to cleanliness, not only of person, but of houses and 
lots. Every source of noxious exhalations should be cleansed and 
sprinkled with lime. The cabins of negroes, particularly, should be 
examined frequently, and cleansed and whitewashed. 

The negroes should be examined daily, and should any of them 
be affected with the premonitory symptoms, they should be promptly 
treated. They should be cautioned against the indulgence of their 
appetites, and informed of the articles they should avoid. 

The diet should be light and nourishing. Garden vegetables 
(Irish potatoes excepted,) should be avoided or sparingly used, and, 
if used, should be well seasoned. Rice is one of the safest articles 
of diet. 

Old habits should not now be altered. A man accustomed to 
strong drink should continue its use ; but the sooner he leaves it off, 
after the epidemic disappears, the better will it be for his health both 
of body and mind. The clothing should be warm ; the feet, espe- 
cially, should be warmly clad. Heavy suppers should be particularly 
avoided, as the disease generally makes its attack about midnight, or 
early in the morning. By attending to these directions, and avoiding 
the causes, the disease will certainly be prevented. 

The following articles should be kept in readiness ; namely : A 
lancet, calomel, mercurial ointment, rhubarb, castor oil, Croton oil, 
magnesia, ipecacuanha, laudanum, oil of cinnamon, cloves, camphor, 
mustard, and Cayenne pepper. 



DIARRHCEA, 
OR LOOSENESS. 



Symptoms. — A purging without sickness or pain, succeeded by 
loss of appetite. 

Causes. — Acid or putrid aliments ; obstructed perspiration ; acrid 
bile; drinking bad water; worms; violent passions; or a translation 
of morbid matter of other diseases to the bowels. 
40 



314 DIARRHCEA, 

Treatment. — If offending matter be lodged in the stomach, give 
an emetic, and an opiate at bed-time ; and on the succeeding day, if 
the disease be not removed, a dose of rhubarb or castor oil, followed 
by forty or fifty drops of laudanum at night. 

In every case where the diarrhoea continues obstinate, an emetic 
should be premised. It relieves the stomach from acrimony, checks 
the increased peristaltic motion downward, and determines to the 
skin. After the emetic, it is necessary to procure some respite, and 
with this view opiates may be employed with perfect safety. By 
lessening or stopping the peristaltic motion, we relax any spasmodic 
stricture which may prevent the discharge of offending matter, and 
the gentle laxatives afterwards required, will have a more salutary 
effect. By thus alternating the opiates and laxatives, we at last 
succeed in relieving the bowels from the irritation of offending matter, 
and moderately warm astringents will complete the cure. Opiates 
may sometimes be given in clysters, and in this way they affect the 
head in a less degree than when swallowed. 

If the disease be in consequence of cold, or the skin be dry, the 
antimonial mixture, or Dover's powder, exhibited in small doses 
during the day, and the anodyne sudorific bolus or draught, (see 
Dispensatory,) repeated at bed-time, with a flannel shirt, will gene- 
rally effect a cure. 

When bile is indicated to be the cause, the Columbo in decoction 
or powder, will be found admirable ; and if accompanied with sour 
and debilitated stomach, the tonic powders or pills, (see Dispensa- 
tory^) with exercise, are the best remedies. Where bad water is in 
fault, it should instantly be changed or corrected by wine, brandy, 
or porter; remembering, that in all cases of continued evacuation, 
laudanum may be given at night after the stomach and bowels have 
been cleared. 

When worms induce this disease, which may be known from the 
sliminess of the stools, and bad breath, such medicines as are calcu- 
lated to destroy them must be employed, afterwards a wine-glass full 
of lime-water with an equal quantity of new milk, will be proper 
three times a-day. 

In obstinate cases no medicine is superior to the continued use of 
the vitriolic solution, (see Dispensatory^) with an opiate at bed-time. 
The nausea which this medicine produces is very disgusting ; but 
from this circumstance much of its efficacy is derived. Should a 
common dose fail to nauseate, it should be increased until that 
symptom is effected. 

The jelly of slippery elm, and the blackberry, (see Materia Medi- 
cal) conjoined with a small portion of cinnamon, ginger, calamus, 
or some aromatic, are also valuable remedies. 

According to domestic practice, the efficacy of burnt cork is highly 
extolled in this troublesome complaint. A friend of mine, of Balti- 
more, informed me that he administered this medicine to three 
gentlemen who had their bowels very much disordered by a change 



DIARRHOEA, OR LOOSENESS. 315 

of water, and that it afforded them immediate relief. He also stated 
of having given it to a child afflicted with the dysentery, in its chronic 
form, with the most happy effects. He directs a bottle cork to be 
burnt to a coal ; and after reducing it to a fine powder, it is to be 
moistened with spirits, and then mixed with a little milk and a lump 
of sugar. Half of this mixture is to be given to an adult, and about 
one-third to a child of two or three years of age, repeating the dose, 
if necessary, in an hour. From the astringent properties of this 
medicine it is proper to remark, it should never be employed in af- 
fections of the bowels, attended with fever. 

Regimen. — The diet should consist of arrow-root, sago, rice, milk, 
and the white meats. The drinks may be of the diluting kind, 
as already enumerated : genuine wine may also be allowed, if it 
do not turn sour on the stomach. Moderate exercise is peculiarly 
useful, and nothing facilitates the cure more than flannel next to 
the skin. # 

* This was the " Angel in disguise." That opened the prison doors of this 
uneasy life, and gave happy freedom to my ever-revered father, Colonel Jesse 
Ewell, of Virginia. My sister Charlotte celebrated his virtues in an Elegy, 
the following extracts from which I beg permission of the reader to insert, as 
a small tribute of gratitude to the best of parents, and but a faint portraiture 
of his worth. 

" Early he woo'd fair virtue for his guide, 

And rarely wandered from her guardian side; 

By him the needy never were denied, 

He sooth'd their sorrows, and their wants supplied. 

He mourn'd the contests of the neighbouring poor, 

And opened wide his peace-restoring door ; 

Where soon his wisdom taught their strifes to cease, 

Revived their loves, and sent them home in peace. 

The slaves whom Heaven to his care consigned, 

Ne'er felt the terrors of a slavish mind ; 

Well fed, warm-clad, to moderate labours prest, 

They loved their fetters, and their bondage blest. 

As friend — as father — who his praise can tell? 

Where first begin, or with due raptures swell ? 

To check our wrong, his frowns were ever light, 

And sweet his smiles whene'er we chose the right, 

And when at length the awful hour drew nigh, 

To waft his spirit to its native sky, 

Such in that moment, as in all the past, 

" O bless my children, Heaven ! " was still his last. 

Now 'scaped from earth, with God he dwells above, 

And shares with angels in their feasts of love. 

Then come, blest faith, come hasten to my aid, 

Lest grief profane disturb his happy shade ; 

Teach me to bow submissive — and adore 

The unerring counsels of eternal power, 

Which gives in love or still in love denies, 

And makes e'en " crosses blessings in disguise." 

And thou, fond memory, still my sire recall, 

Record his virtues, imitate them all — 

That joys like his my mortal life may prove, 

And peace eternal crown my state above." 



316 DROPSY. 

DROPSY, 

A collection of water in some part of the body. 

Symptoms. — In common dropsies the legs usually swell, and a pit 
remains for some time after pressing the flesh ; the appetite abates ; 
the face is bloated ; urine little ; thirst great, with slow fever, short- 
ness of breath, and lassitude. 

Causes. — Excessive drinking ; poor diet; protracted intermittents ; 
scirrhous tumours of the abdominal viscera, but particularly of the 
liver, and in fine, whatever may occasion too free a secretion of the 
serous fluids in the cellular membrane, or any cavity of the body, 
and at the same time diminish the action of the absorbent vessels. 

Treatment. — Like other diseases, the treatment must vary ac- 
cording to circumstances. In every form of dropsy, if there be a 
hard, full, and quick pulse, blood-letting constitutes one of the prin- 
cipal remedies, and must be repeated once or twice a-week, until the 
action of the arterial system is considerably diminished. 

Brisk purges, as calomel and jalap, cream of tartar and jalap, or 
the Croton oil, (see Dispensatory,) in full doses, are indispensable, 
and ought always to succeed bleeding, and be given as often as the 
patient's strength will admit, followed by Dover's powder, or the 
anodyne sudorific bolus or draught, at bed- time. (See Dispensatory.) 

The discharge from the intestines is unquestionably of the greatest 
importance in dropsy; and when obstructed perspiration is the cause, 
sudorifics are much to be depended upon. However, this distinction 
must be made : If purgatives be accompanied by violent colics, and 
weakness be the consequence, without producing a considerable dis- 
charge, the remedy must be discontinued; but if they operate without 
pain and inconvenience, the stools watery, and weakness do not 
follow, whatever the number of evacuations may be, the remedy 
is good. And if, on the employment of sudorifics, they tend to 
weaken the system, in general, too much, they should not be 
persisted in. Another remark to be attended to is, that in every 
species of dropsy attempted to be cured by internal means, how- 
ever they may be relieved by different evacuations, unless the 
urinary organs continue their evacuating power, the cure will never 
be lasting. 

While feverish symptoms continue, nitre is extremely useful in 
this disease, in doses of ten grains four or five times a-day, or in such 
quantities as the stomach may bear ; but should not be continued 
longer than two weeks, if no good effects result from its use. An- 
other valuable medicine for lessening the action of the pulse, and 
thereby increasing absorption, is the foxglove, (see Materia Medica,) 
which may be given in powder, decoction, or tincture. The latter 



DROPSY. 317 

is the most convenient form, and in doses of twenty or thirty drops 
in a wine glass of mint- water, may be taken twice or thrice a-day, 
until the water be removed, or the inflammatory disposition taken 
ofT. If this quantity do not induce sickness, or produce any evidently 
good effect, the dose must be gradually increased to forty or sixty 
drops, or more. 

Cream of tartar, from half an ounce to an ounce, dissolved in a 
pint or more of water, is a pleasant and useful drink; and this 
taken early in the morning has frequently succeeded in evacuating 
the water. 

As soon as the action of the pulse becomes lessened, it is necessary 
to strengthen the system and increase the digestive powers, by the 
nitric acid or the exhibition of steel alone, or the tonic powders, pills, 
or drops, (see Dispensatory^ thrice a-day during the intervals of 
purging. 

One of the most frequent causes of dropsy is obstructed liver; 
and when this is suspected, mercurial friction must be resorted to, or 
a grain or two of calomel, conjoined with a few grains of powdered 
squills, given night and morning, until ptyalism be produced, and 
afterwards the nitric acid, and other tonics, constitute the proper 
remedy. The squill in every form, is a valuable medicine, and suc- 
ceeds in the greater number of dropsical cases. United with cream 
of tartar and a small portion of jalap, it is highly useful as com- 
bining a diuretic and purgative effect ; and with the resin of jalap 
and gamboge, in pills, its utility is almost unrivalled. The efficacy 
of this medicine is also highly extolled in dropsies, in doses from 
five to ten grains, with double the quantity of nitre. It should be 
observed, however, the squill seldom increases the discharge of urine 
to any degree, till raised to a nauseating dose. 

The juice of leeks, in doses of a table-spoonful twice a-day, is said 
to have performed surprising cures ; at any rate, in this state of the 
disease the patient can hardly make too free a use of the acrid stimu- 
lating vegetables, as garlic, onions, horse-radish, &c. 

Tight bandages applied in the morning round the belly and limbs, 
have their good effects in preventing the increase or return of drop- 
sical swelling. Friction, with a flesh brush or flannel, every morning, 
from the extremities upwards, is of the greatest service, particularly 
if the skin be previously moistened with a liniment, composed of 
equal parts of soap, spirit, and vinegar; or with the volatile or 
camphorated liniment. 

Persons recovering from lingering diseases are very subject to 
anasarcous swellings, particularly if they replenish their weak vessels 
too fast by full diet. 

Scarifications with a knife are much commended when the legs 
and thighs are turbid with extravasated serum ; and, indeed, the 
water is speedily discharged this way; but the lips of the wound will 
close in two days, so as to admit of no discharge ; and from a defect 
of heat in the constitution, the part is apt to mortify. Dr. Fothergill 



318 DROPSY. 

to obviate these difficulties, advises this operation to be performed 
with the common scarificator used in cupping, and the instrument to 
be placed so as to make the wounds transversely. If the skin be 
thick, the lancet may be so set as to make deeper, and, consequently, 
wider incisions ; thus, a large quantity of water will often drain from 
the legs or thighs, without risk of inflammation, or deterring the pa- 
tient from a repetition, if necessary. The punctures must be made 
in the most depending part of the leg ; and their number and repeti- 
tion depend on the circumstances of each individual case. The 
application of glasses, either before or after scarifying, is unnecessary; 
but the instrument must be gently pressed upon the skin, until a 
surface is formed sufficiently flat to admit the lancets in the scarifica- 
tor to act equally. In all cases where the skin is so stretched as to 
threaten inflammation, rupture, or a gangrene, and when the breath 
is greatly impeded, these openings should be made without delay. 
Blisters are often employed in the same circumstances instead of 
scarifications, and are equally useful. An oblong blister may be 
applied just above the inner ankle, and continued until a thick, 
white, or purulent discharge is produced. After this period but little 
water appears, and the sore should be healed. If necessary to be 
longer continued, blisters may be employed on the outside; and 
when these have acted sufficiently, we may return to the former 
surface, which will be now healed. Should a dark or black spot 
appear, bathe the leg in a strong decoction of oak, and sprinkle 
the spot with some of the bark, or myrrh powdered, or apply poul- 
tices of charcoal and bark, which will soon separate it, and arrest 
the mortification. 

When the difficulty of breathing is considerable, relief will very 
generally be obtained by expectoration ; and for this purpose, pretty 
large doses of gum ammoniac with the squill, or seneca infusion may 
be repeated as the occasion requires. The infusion of garlic is often 
useful, and assafoetida, in the form of pills or tincture, relieves the 
difficulty of breathing when it is connected, as is often the case, with 
wind in the stomach occasioning hysteric affections. 

Spasms often arise in particular parts, especially about the chest, 
frequently awaking the patient out of a sound refreshing sleep. In 
such cases, a grain of opium, with five of camphor, is the most ef- 
fectual remedy. 

When the duplication of the peritoneum is the seat of dropsy, tap- 
ping is alone the remedy. 

Regemen. — During the inflammatory disposition, or when there 
is a preternatural heat on the skin, or much action in the pulse, the 
diet should be light, and easy of digestion. In the other state, when 
the patient is weak and feeble, it should be of the most nourishing 
kind, with a liberal use of wine. The patient may, in general, 
drink in proportion to his inclination. Acid liquors, as lemonade, 
cider, the imperial drink, or wine, or gin and water may be allowed ; 
and thirst is often prevented by holding nitre in the mouth. 



GOUT. 319 

Exercise is one of the greatest importance when not carried to fa- 
tigue. In the lowest stage of the disease, swinging or riding in a 
carriage are most proper ; but as soon as the patient's strength will 
admit of it, riding on horseback will be found most beneficial, 



GOUT 

Is often hereditary, but, generally, indolence and luxury, the 
hated parents of this disease, which righteous Heaven has marked 
with such severity, that, like the leprosy of Naaman, it is hardly ever 
curable.* 

But though art has not often succeeded to cure the gout, yet it has 
discovered a variety of means to shorten the fits, and to render them 
much more tolerable. 

Symptoms. — The gout mostly affects the joints, but the viscera 
are not exempt from its ravages. It sometimes comes on suddenly, 
passing from one part of the body to the other, in the twinkling of 
an eye ; but generally is preceded by indigestion, flatulency, loss of 
appetite, unusual coldness of the feet and legs, with frequent numb- 
ness, sense of pricking, and cramp. These symptoms take place 
several days before the paroxysm comes on, but commonly the day 
preceding it, the appetite becomes greater than usual. The next 
morning, the patient is roused from his sleep, by an excruciating 
pain in the great toe, or ball of the foot, resembling the gnawing of 
a little dog. 

Treatment.— No matter what part of the body this disease first 
seizes, the lancet will be required in every case where there is an 
increased action of the pulse, to take ofT the inflammatory disposition. 

The extent to which the blood-letting must be carried, can only 
be ascertained by the violence of the disease, and the sex and con- 
stitution of the patient. In this, as in all inflammatory fevers, the 
bowels ought to be kept open freely by laxative medicines, as castor 

* An English nobleman, after twenty years' riotous living, awoke one morn- 
ing in the torments of the gout. As he lay writhing with pain, his servant 
ran up stairs to him with great joy in his countenance : " O ! sir, good news ! 
good news ! there is a famous gout doctor below, who says he will venture 
his ears, he can cure your honour in less than a week." " Ah, that is good 
news indeed, Tom. Well, run, my good boy, and put up his carriage and 
horses, and treat the doctor like a prince." " O sir, the gentleman has no car- 
riage and horses; I believe he walked a foot!" "Walk a foot! what! cure 
the gout and walk a foot! go down, Tom, go down, and instantly drive the 
rascal out of the house; set the dogs upon him, do you hear? the lying 
varlet! why, if he could cure the gout, he might ride in a richer carriage than 
his majesty." 



320 GOUT. 

oil, sulphur, cream of tartar, rhubarb, senna, jalap, or calomel. 
Indeed, a fit of the gout may be oftentimes entirely, and is almost 
instantaneously, removed by active purging-. Even drastic purges 
need not be dreaded in this disease. 

Nitre, with diluting liquors given in such quantities as to excite a 
gentle perspiration, are of great utility in the inflammatory stage of 
the disease. After the action of the pulse is somewhat reduced 
by evacuations, blisters over the pained parts are greatly to be 
relied on. 

As soon as the inflammatory state of the gout has subsided, stim- 
ulants and tonic medicines, as bark and steel, are the best remedies. 
Laudanum, ether, good French brandy, and aromatice, as calamus, 
ginger, Virginia snake-root, and red pepper, (see Materia Medica,) 
in the form of teas, are all exceedingly useful in this feeble state of 
the disease, especially when it affects the stomach or bowels. Be- 
sides these internal remedies, friction on the stomach and bowels, or 
the application of cloths wrung out of hot spirits or water, over the 
pained parts, and sinapisms to the feet, should be employed when- 
ever the gout attacks the head, lungs, bowels, or stomach. 

Gentlemen long in the habits of intimacy with this disease, should 
remember that it is of immense rudeness, and ready on the slightest 
provocation to quit the toes and knuckles, and seize on the very sto- 
mach and bowels of its best friends. They should, therefore, be 
constantly on their guard, and keep always by them a vial of ether 
or laudanum, or a case of good old French brandy ;* the latter of 
which is admirable for chasing the gout from the stomach. 

The white hellebore (see Materia Medica,) is highly extolled as 
a remedy in this distressing disease. 

Regimen. — The diet should be regulated according to the state 
of the patient. If feverish, and of a plethoric habit, the lightest diet 
ought to be used. If debilitated and of a relaxed habit, generous 
diet should be allowed. Exercise, although painful at first, must be 
freely taken. 

Prevention. — If the person be plethoric, and has been accus- 
tomed to drink freely of wine, and eat heartily, he should gradually 
diminish the quantity of the aliment ; particularly every spring and 
fall, as the disease is more liable to recur at those seasons than at any 

* For lack of this ammunition, the gallant Wayne was cut off long before 
" his eye was dim, or his natural force abated." Late in December, 1796, he 
embarked at Detroit for Presque Isle, but not without his usual supply of 
brandy, which, however, was all lost, through his servant's carelessness in 
upsetting his case. On the passage he caught cold, which brought on a 
violent attack of the gout in the stomach ; and, for want of his usual remedy, 
he suffered the most excruciating torture until he reached Presque Isle, where 
he died early in January, 1797. His body was deposited in the centre of the 
fort, to show the children of future days the grave of him who so bravely de- 
fended their liberties. Filial piety has since removed it to his native state, 
where it now sleeps with the dust of his fathers. 

I am happy to acknowledge, that for this anecdote, I am indebted to the po- 
liteness of my worthy friend, Captain Hugh M'Call, of Savannah. 



VENEREAL DISEASE. 321 

other time. But in debilitating habits predisposed to the gout, a 
stimulating diet is most proper assisted with the use of the rust of 
steel, bitters, or bark in every case, costiveness should be avoided; 
and flannel worn next to the skin is peculiarly proper. Nothing, 
however, prevents this disease, more than temperance and exercise.* 



VENEREAL DISEASE. 

The venereal disease is of two species; the one a local affection 
of the genital organs, termed Gonorrhoea, or Clap ; and the other 
a general or a constitutional complaint, termed Syphilis or Pox. 

THE GONORRHOEA, 

Of which we shall first treat, is an inflammation of the mucous 
membrane, lining the urethra in men, and the vagina in women ; 
seated in the male about the freenum of the penis, and in the female 
a small distance up the vagina ; but in its progress communicating 
to all the surrounding parts, and producing a variety of painful 
sensations. 

Symptoms. — A discharge of mucus, at first white, but soon turn- 
ing of a yellow or greenish appearance, an acute or scalding pain in 
making water, with most, indecent erections of the penis, termed, 
chordee, very painful, and sometimes followed by a discharge of 
blood. At times the inflammation spreads to the contiguous parts, 
occasioning strangury, swelled testicles, swelling in the groin similar 

# The story of the wealthy Mr. Palmer, in the reign of George I., though 
well known to many, is yet so apropos to our subject, that I cannot deny my- 
self a wish to relate it. Young Mr. Palmer received from his father, what 
the London merchants call a plum (that is a round 100,0007.) of which he 
contrived to make such " good use," that by the time he was forty years of 
age, he was torn to pieces by the gout. His physicians advised him to try 
the virtues of a sea voyage with the soft balmy air of Montpelier. He set out, 
but on his passage up the Mediterranean, was captured by an Algerine corsair, 
who took him to Morocco, and sold him for a slave. He was bought by a 
farmer, who carried him into the country, and set him to hard labour, allow- 
ing him nothing better than brown bread and dates, and even of that hardly 
enough to support him. His only drink was water, and his only bed a plank. 
In a few weeks every gouty symptom disappeared, and he recovered his 
health, with an uncommon portion of activity. 

These first of blessings continued with him all the time he was in captivity. 
(two years;) at the expiration of which he was ransomed by his friends. On 
his return to England, he was hardly known by his acquaintances, so great 
was the change which temperance and exercise had wrought upon him. But 
alas ! for the lack of fortitude, he soon relapsed into his old passion for the 
rich dishes, flowing glasses, and soft couches of Epicurism. His system 5000 
became bloated and relaxed, and his ancient foe, the gout, returned, and killed 
him in a short time. 

41 



322 VENEREAL DISEASE. 

to buboes, or a contraction and thickening of the fore-skin, which, 
when drawn over the head or nut of the yard, is termed phimosis, 
and paraphym,osis when retracted behind it. 

When these symptoms dance their attendance to the catastrophe, 
the clap may be said to flourish in its full bloom, and the patient 
finds himself fairly seated on the stool of repentance. 

The appearance of clap in the female is pretty much the same as 
in the male, allowing for the difference of the parts. The disease, 
in them, is always milder ; insomuch, that at times there is no other 
symptom but the discharge, which is often mistaken for the fluor 
albus. They are, however, more subject to excoriations of the parts 
than the men, and, indeed, when the inflammation is considerable, 
it often extends to the urethra, and occasions great pain. 

Treatment. — In the general treatment of gonorrhoea, rest, toge- 
ther with abstinence from strong food, and every thing of a heating 
nature, is of the greatest consequence ; and this alone, with little as- 
sistance from medicine, will complete the cure in a short period. 

As the disease is local, topical applications in the form of injec- 
tions become necessary. The patient should, therefore, without de- 
lay, employ one of the injections (see Dispensatory,) which, in irri- 
table habits, must be a little weakened, and the strength gradually 
increased as the inflammation abates. Indeed, when the inflamma- 
tion is very considerable, it is better, at first, to inject with sweet oil 
or mucilage of sassafras, (see Materia Medico,,) and in such cases 
the testicles ought to be suspended by a bandage, and the anti- 
phlogistic regimen strictly adhered to, particularly in taking freely 
of mucilaginous drinks, as flax-seed tea, barley water, or the muci- 
lage of gum Arabic, and obviating costiveness, by small and repeated 
doses of cream of tartar. Whichever of the injections is used, it 
must be thrown up the urethra six or eight times a-day, immedi- 
ately after making water, and with a syringe that works easily, that 
it may not hurt or inflame the parts. It should be observed, if as- 
tringent injections of full strength be used in the early period, they 
often prolong the disease, and occasion swelled testicles, strictures, 
and enlargement of the prostrate gland ; but after the inflammatory 
state is removed, they may be employed with safety, and will be 
found to facilitate the cure. Frequently bathing the part, and the 
greatest cleanliness, are too important to be neglected ; particularly 
washing under the glans, to prevent the accumulation of the fluids 
from the odoriferous glands, which produces irritation, inflammation, 
and often ulcers. 

For the chordee, which is more severe during the continuance of 
the inflammation, and occurs mostly in the night, while the patient 
is warm in bed ; take, on going to rest, a dose of laudanum, or souse 
the guilty member frequently in a vessel of cold water. Should a 
hemorrhage supervene, it may be removed by rest, and immersing 
the part often with cold vinegar and water, or lead-water, of the 
ordinary strength, of which the patient may throw a little up. 



VENEREAL DISEASE. 323 

According to Professor Chapman, no remedy succeeds better in 
the cure of gonorrhoea than balsam copaivi. He commences with 
this medicine on the very accession of the disease, regardless of all 
the appearances of inflammation, such as scalding, chordee, &c. 
The proper dose is about forty drops, more or less according to cir- 
cumstances, to be repeated morning, noon, and night. He directs 
it to be taken in a little wine, or milk, or if it should act on the 
bowels, or be offensive to the stomach in this way, he advises it to 
be exhibited, agreeably to the following prescription: Take of 
balsam copaivi and sweet spirits of nitre, of each half an ounce, 
the white of an egg y or powdered gum Arabic and white sugar, 
each two drachms, mix, and then add laudanum, one drachm, and 
water three ounces : of this mixture, the dose is a table-spoonful 
three times a-day. One caution, he suggests, should always be en- 
joined on patients who are desirous of a speedy cure: An entire ab- 
stinence from every heating article of food or drink, and a state of 
complete repose. 

He says, contrasted with the ordinary mode of treating it by in- 
jections, his plan has several advantages. It is more convenient to 
the patient ; it produces no swelled testicles ; it occasions no stric- 
tures; it leaves no gleet; it is more prompt and certain in the cure. 
Of the efficacy of this remedy, coming from such unquestionable 
authority, there can be no doubt ; but candour compels me to ac- 
knowledge I have never resorted to it, having uniformly succeeded 
in the cure of gonorrhoea by injections, as above advised. 

When the inflammatory symptoms of gonorrhoea increase to a 
violent degree, a swelling or inflammation of one or both testicles 
sometimes supervenes. The same consequence is often produced 
by astringent injections imprudently exhibited. In such cases, the 
general remedies for allaying inflammation, as blood-letting, cooling 
cathartics, diluent drinks with small portions of nitre dissolved in 
them, become necessary. Besides which, the testicles must be sus- 
pended by a bandage, and kept constantly moistened with cloths 
wrung out of lead- water, or cold vinegar and water, often renewed. 
The swelling of the glands in the groin, and of the spermatic chord 
itself, require a similar treatment. In these affections, a horizontal 
posture, and spare diet, are particularly enjoined. In case of much 
pain, with little or no fever, an opiate may be given at bed-time. 
And if hardness remain after the pain, the patient should have 
mercurial ointment rubbed on the part, night and morning, and 
take freely of a strong decoction of sarsaparilla. But if the swell- 
ing without hardness follow, one or two vomits, succeeded by 
tonic medicines, with the use of the cold bath, will generally effect 
a cure. 

In case of phimosis, cold applications to the penis, as lead-water 
or cold vinegar and water, and topical bleeding with leeches, con- 
stitute the proper remedies. Besides which, soap-suds should be 
often injected with a syringe between the skin and the glans, to 



324 VENEREAL DISEASE. 

prevent the stagnation of matter, the extreme acrimony of which 
might otherwise produce a mortification of the parts. When these 
means, assisted by opiates, fail, an operation becomes necessary ; it 
is simple, and by no means dangerous. A sharp-pointed knife, 
concealed, and defended by a grooved directory, which must be 
previously introduced betweeu the prepuce and glans, are the only 
instruments required. The point of the knife should pass through 
the prepuce at the bottom, and the section be made by drawing it 
towards the operator. Common dressings are sufficient ; but linen 
or lint should be interposed between the glans and the prepuce, to 
prevent adhesions. 

Paraphymosis is the opposite disease, where the prepuce cannot 
be drawn over the head of the penis; and in this case, bathing the 
part frequently in milk and water or soap-suds, and taking some 
cooling laxative medicine, will generally effect a cure. When the 
inflammation is considerable and long continued, a mixture of 
syphilitic infection may be suspected, requiring a mercurial course. 
Indeed, these affections frequently originate from chancres. 

Gonorrheal inflammation of the testicle and its appendages has 
been speedily and completely cured by purgatives, followed by the 
administration of opium. Hyoscyamus has been found to answer 
the same end as opium. The free and full operation of a previous 
purgative has been found essential in order to secure the advantage 
of the opiate. 

M. Velpeau uses balsam copaiva in the form of injection w T hen 
the stomach rejects it. He mixes one drachm of the balsam with 
four ounces of a viscid fluid and a little opium. This he injects up 
the rectum, and has been very successful with it. 

He also uses balsam combined with cubebs in the following pro- 
portions. Copaiva two drachms. Cubebs six drachms. Powdered 
opium two grains — and then adds enough of carbonate of magnesia 
to form a paste. This to be divided into six parts — one to be taken 
three times a-day for three days. Then omit one day and take 
again for three days. A favourite prescription of the same distin- 
guished individual is the nitrate of silver in the form of injection — 
one grain to the ounce of distilled water. Mr. Carmichael uses one- 
fourth grain to the ounce of water. Before using it care is to be 
taken, to make compression upon the bulb and membranous portions 
of the penis by a compress and retained by a bandage. 

Such are the principal symptoms which attend gonorrhoea. Its 
consequences, which induce a new state of disease, after the original 
affection is removed, are no less important. 

GLEET. 

This is known by a constant discharge of mucous matter, after the 
inflammatory symptoms have subsided, occasioned by a relaxation 
of the mucous glands, or stricture in the urethra. A discharge of 



VENEREAL DISEASE. 325 

this kind may also be occasioned by hard drinking, violent exercise, 
or straining. 

A discharge of mucus, if not connected with venereal taint, even 
when accompanied with inflammation, which have been excited by 
high living, or violent exercise, is not infectious. 

Treatment. — Although this disease often yields with great 
facility to the common remedies, yet it is sometimes peculiarly dis- 
tressing and obstinate. 

The remedies generally employed are astringent injections ; the 
use of balsam copaiva, in doses of thirty or forty drops thrice a-day, 
and tonics of every kind, particularly cold bathing, both partial and 
general. In obstinate cases, the uva ursi, (see Materia Medica y ) 
as well as the tincture of cantharides, have often succeeded. None 
of the remedies should be continued longer than eight or ten days, 
if they produce no salutary effects. They often in this time remove 
the complaint which recurs on their being discontinued, so that they 
should be employed long after the discharge has ceased. The tinc- 
ture of cantharides may be given conjointly with balsam copaiva, or 
alone in common drink. This remedy must be cautiously employed, 
beginning with very small doses, about fifteen drops of the tincture, 
which may be gradually increased daily, as in the irritable state of 
these organs even a common dose may excite dangerous inflamma- 
tion. The application of a blister to the sacrum, or blistering the 
urethra, in its course, has sometimes succeeded. Upon high authority 
an obstinate gleet was cured by the injection of punch, a remedy 
suggested in a convivial moment; at another time by green tea; 
and again by a decoction of red oak bark. An astringent injection 
of considerable efficacy in obstinate gleets, is prepared by dissolving 
twenty or thirty grains of alum in a half pint of water, which should 
be injected up the urethra, twice or thrice a-day. 

When an ulcer in the urethra is the cause, which may be sus- 
pected, if on pressing the penis slightly erected, between the finger 
and thumb, one part be found more sensible to the touch than an- 
other, the best remedy which has come under my notice in practice, 
is an injection composed of one or two grains of corrosive sublimate 
in a half pint of water, or made of sufficient strength to excite some 
degree of inflammation in the part affected. If a stricture be the 
cause, the introduction of a bougie is the only remedy. While the 
use of a bougie is continued, the discharge usually proceeds, but 
after three weeks or a month, it should be omitted. If the running 
stops, the cure is usually effectual ; if it continues, the remedy should 
not be repeated. 

In women, gleets are equally obstinate, but they generally pass 
under the appellation oifiuor albus or ivhiles. 

SEMINAL WEAKNESS 

Is another consequence of clap, when there has been frequent 
returns of it, and is known bv an involuntary discharge of the semen. 



326 pox. 

At the beginning of the disease there is a great inclination to erec- 
tions, and the emission of the semen is attended with pleasure ; but 
gradually the penis becomes lame, the testicles hang lower than 
usual, and unless they are otherwise suspended, become almost a 
burden to the possessor. 

Although veterans in the wars of Venus, are most liable to be 
complimented with this kind of gleet, yet it may originate from other 
causes, as self-pollution, a sudden lift or strain, hot clysters, straining 
to stool, or the imprudent use of strong diuretics. Let the cause, 
however, be what it will, there is no drain which steals away the 
quintessence of life and strength more rapidly. 

Treatment. — If the emission take place on the slightest irrita- 
tion, as heat, wine, <fcc, and be attended with some degree of spasm, 
it is a sign the patient is in a very rampant state, and can hardly get 
him a wife too soon. But if it ooze away insensibly, cold bathing 
and tonic medicines, as bark, steel, or balsam copaiva in the usual 
doses, with a generous diet, are the best remedies. Costiveness 
should be carefully avoided. 

OBSTRUCTION OF URINE 

Is another formidable symptom, which sometimes succeeds go- 
norrhoea. It is produced by certain changes of the passage, from 
tumours seated high up in the urethra, or the contraction of the 
urinary canal. 

Treatment. — When this affection arises from tumours, a cure 
may be attempted by the use of the mercurial pills, (see Dispensa- 
tory,) night and morning, and a decoction of sarsaparilla, or meze- 
reon ; but it is often incurable. 

When spasmodic constriction of the passage is the cause, it will 
be removed by the warm bath of fomentations. The penis may also 
be rubbed with camphorated oil, (see Dispensatory,) or equal parts 
of ether and laudanum. If this fail to take off the spasm, bleed, 
and give laudanum in large doses. 



POX 

Is the venereal disease in its confirmed state, manifested by chan- 
cres, buboes, or warts about the genitals. To these succeed ulcers in 
the throat, nose, and tongue, blotches on various parts of the body, 
with nocturnal pains, especially in the shin bones and shoulders. 

The system is now filled with the horrid poison, which, unless 
mercifully arrested, will soon ulcerate the eyes, consume the nose, 
contract the body, and convert the loveliest form into such a mass 
of corruption, such a dunghill of stench, such a picture of ghastli- 
ness, as is sufficient to strike the guilty person with terror. 



pox. 327 

A pallid youth, beneath a shade, 

A melancholy scene displayed ; 

His mangled face, and loathsome stains, 

Proclaimed the poison in his veins ; 

He raised his eyes, he smote his breast, 

He wept aloud, and thus addressed : 

"Forbear the harlot's false embrace, 
Though lewdness wear an angel's face ; 
Be wise, by my experience taught ; 
I die, alas! for want of thought." — Cotton. 

ELEGY. 

" Weep o'er the sorrows of a wretched maid, 
Who sacrificed to man her health and fame : 
When love, and truth, and trust, were all repaid, 
By want and wo, disease and endless shame. 

" Curse not the poor lost wretch, who ev'ry ill 
That proud unfeeling man can heap, sustains ; 
Sure she enough is cursed, o'er whom his will, 
Inflam'd by brutal passion, boundless reigns. 

" Spurn not my fainting body from your door, 
Here let me rest my weary, weeping head j 
No greater mercy would my wants implore ; 
My sorrows soon shall lay me with the dead. 

"Who now beholds, but loathes my faded face, 
So wan and sallow, chang'd with sin and care? 
Or who can any former beauty trace, 
In eyes so sunk with famine and despair? 

"That I was virtuous once, and beauteous, too, 

And free from envious tongues my spotless fame, 
These but torment, these but my tears renew, 
These aggravate my present guilt and shame. 

"Where are my virgin honours, virgin charms? 
Oh ! whither fled the pride I once maintained ? 
Or where the youths that woo'd me to their arms ? 
Or where the triumphs, which my beauty gain'd? 

" Ah ! say, insidious demon ! monster ! where ? 
What glory hast thou gain'd by my defeat ? 
Behold the miseries I am doom'd to bear, 

Such as have brought me to my winding-sheet." 

Treatment. — Happily for mankind, the Governor of the world, 
is " a Father who pitieth his children" and afflicts not to kill, bm 
to cure. In mercy he has appointed a medicine for this dreadful 
malady. A medicine, which, when taken in sufficient quantity, 
quickly flies to all parts of the system, attacks the disease at every 
post, drives it from gland to gland, and with a fidelity and courage 
truly admirable, never gives it rest until it has completely expelled 



328 pox. 

it from the body, and restored the patient to former health and vi- 
gour.. This wonderful medicine is mercury, which requires only 
to be so managed as to obtain full possession of the system ; not ex- 
ceeding it by salivation, nor falling short of it by untimely purging. 
To hit this desirable point, let a table-spoonful of mercurial solution 
or one of the mercurial pills, (see Dispensatory,) be given night and 
morning, until the system is fully charged with the medicine, which 
may be known by a slight soreness of the mouth and gums, and 
fetid breath. This fortunate state of things, carefully supported a 
few weeks, will remove the disease. 

If the mercury affect the bowels, lessen the dose, or give it at 
longer intervals, or use the mercurial ointment ; and if there be an 
increased secretion of the salivary glands, we should omit the mer- 
cury for a few days, and take a tea-spoonful of flour of sulphur, in a 
glass of milk or flax-seed tea, night and morning. 

In this way the disease may generally be cured in a short time. 
It will always be prudent to continue the mercury in small doses 
for ten or twelve days after the total disappearance of all the 
symptoms. 

There are cases, however, where mercury will not answer, as in 
those of scrofulous habits, and when the blood is vitiated. In these, 
the nitric acid should be preferred, and from one to two drachms of 
it, diluted, (see Dispensatory,) may be taken in the day. This 
medicine seems especially adapted to cases where the habit of body 
is much debilitated, from the long continuance of the disease, or 
where it has acquired great irritability from an incautious use of 
mercury. It is also a sovereign cure of spongy gums, eruptions, 
ulcers, nocturnal pains, and all the train of consequences, usually at- 
tendant on this disease, when of long standing and imperfectly cured. 

In the treatment, therefore, of venereal patients, too much atten- 
tion cannot be paid to mark the peculiarities of habit; and we 
should always remember, that, when unfavourable appearances 
supervene from the use of mercury, other medicine, as the nitric 
acid, or tar water, (see Dispensatory^) or decoctions of prickly ash, 
mezereon, lobelia, sarsaparilla, sumach, or poke bounce. (See Ma- 
teria Medica.) 

In this disease, there are certain symptoms which require local 
treatment. Thus, a chancre, which is a small red pimple, termina- 
ting in ulcer, with hard edges, and generally situated on some part 
of the prepuce, or the fore skin of the penis, is best removed by the 
application of caustic ; or, if recent, washing with spirits or brandy, 
a solution of alkali, (see Dispensatory,) and applying dry lint to the 
sore, with cleanliness, will generally prove sufficient. 

When a bubo supervenes, which is known by pain and swelling 
in the groin, every attempt should be made to disperse it by rubbing 
in mercurial ointment on the inside of the thigh or calf of the leg; 
and the application of cloths, wrung out of lead-water, or ice, if it can 
be procured, to the swelling, renewed as often as they become warm 



pox. 329 

Besides which, the patient should be kept still, the bowels open, 
and the pain alleviated by the use of opiates at bed-time. 

When a tendency to suppuration is discovered, instead of the for- 
mer plan, warm poultices of flax-seed, milk and bread, or mush and 
fat, must be applied and renewed three or four times a-day, until 
the tumour break. After which, one or two poultices may be con- 
tinued, to accelerate the discharge of matter, for a day or two; when 
the sore must be kept clean with soap-suds, and dressed night and 
morning with basilicon, spread on lint, until the matter be mostly 
discharged. The sore should then be dressed with lint, dipped in a 
solution of alkali, (see Dispensatory,) once or twice in twenty^four 
hours, as may be indicated by the discharge of matter ; and, lastly, 
when there is no appearance of proud flesh, it may be healed with 
Turner's cerate, or any healing ointment. 

Warts are a frequent affection of the penis, and sometimes remain 
after the venereal virus is expelled. In which case they may be 
removed by ligatures, or the application of caustic. 

Besides the applications mentioned above to discuss buboes, I have 
derived the greatest benefit from the application of a plaster of Jud- 
kin's ointment premised by the use of leeches. 

The following deductions are stated by Dr. Mcintosh after a care- 
ful consideration of all the facts which have been laid before the 
profession respecting the treatment of syphilis. 

First — That mercury is as certain a poison as arsenic only it is 
not so quick in its operation upon the system. 

Secondly — That like many other poisons, it is found useful in the 
cure and alleviation of many diseased states of the constitution, when 
employed with caution and within certain limits, which can never 
be defined to suit all constitutions. 

Thirdly — That it will cure syphilitic diseases, when used judi- 
ciously, not by any specific effects which it has been long supposed 
erroneously to possess in these diseases, but from its having the power 
of altering or modifying diseased actions, both local and general, 
improving the state of the secretions, and thereby disposing sores to 
heal ; but when carried beyond a certain point, which can never be 
defined, mercury produces a disease of its own, always more difficult 
to cure than the primary one for which it was employed. 

Fourth — That all kinds of syphilitic ulcers on the parts of genera- 
tion, including the true Hunterian chancre, may be cured without 
the intervention of mercurial preparations. 

Fifth — That the secondary symptoms do not succeed the non- 
mercurial plan of treatment in nearly so great a proportion as was 
apprehended, and as is still asserted by some of the mercurialise ; 
and that when they do occur, they are generally mild, unattended 
by danger, (which cannot be said of those produced by over-doses of 
mercury,) and can be cured in a great number of cases without the 
use of mercury. 

Sixthly — It would appear to be established by all the medical evi- 
42 * 



330 SCURVY. 

dence which I have had an opportunity of examining, that all the 
primary forms of syphilis are more speedily cured by a judicious use 
of mercury, than by the non-mercurial plan of treatment. 

Regimen. — There is hardly any thing of more importance in the 
cure of this disease, than a proper regimen. Inattention to this, not 
only procrastinates the cure, but often endangers the patient's life. 
In full habits, the diet should always be light and cooling. Exercise 
should never be carried to excess, and the patient should wear flan- 
nel on using any preparation of mercury. Cleanliness is of too much 
importance ever to be neglected. As soon as the disease makes its 
appearance, the infected part should be frequently washed in milk 
and water, or soap-suds ; and if, from a neglect of cleanliness, vene- 
real ulcers appear, the sores must be well cleansed, and dressed with 
dry lint night and morning. In obstinate cases the lint should be 
dipped in the solution of alkali. 

When the patient is in delicate health, or much reduced, a nour- 
ishing diet, with wine, bark, and other tonic medicines, are proper, 
with pure country air. 

Prevention — After a suspicious connexion, it becomes a prudent 
man to discharge his urine as soon as possible, and wash well his 
polluted member, by drawing forward the fore-skin, and closing the 
end with his finger, that it may be distended, and retain for a few 
seconds the urine. The glands and penis should then be well 
washed with strong soap-suds or grog. 

In women, besides cleansing the external parts, some portion of 
the wash should be injected up the vagina, by means of a female 
syringe. 



SCURVY. 



Symptoms. — An unusually weakened state of the body; pale and 
bloated countenance ; the breathing affected on the slightest exer- 
tion ; the gums soft, swollen, and inclined to bleed on being rubbed, 
and sometimes putrid ulcers are formed ; the teeth become loose ; 
the breath fetid ; and the urine high-coloured. The heart is subject 
to palpitation ; the lower extremities to dropsical swellings ; the body 
to pains of a pleuritic or rheumatic kind; besides which, blotches 
and ulcers break out in different parts of the skin, and often termi- 
nate in mortification. 

Causes. — Cold moist air ; vitiated or scanty diet ; and indolent 
life, with luxurious indulgences; corrupted water or provisions; and 
whatever may weaken the body, or vitiate the humours. 



ERUPTIONS OF THE SKIN. 331 

Treatment. — Raw and fresh vegetables of every description, 
particularly those of an acid kind ; and fruits, such as lemons, limes, 
oranges, sorrel, &c., {see Materia Medical) furnish the most effectual 
remedies. But as these are not at all times to be obtained, common 
vinegar, or nitrous vinegar, used freely, will completely answer the 
end. The nitrous vinegar is prepared by dissolving three or four 
ounces of nitre or saltpetre, in one quart of good vinegar ; and of 
this solution, from one to two spoons full may be taken three or four 
times a-day, according to the advanced stage of the disease ; and as 
frequently, some of it may be used in bathing the limbs, where they 
are either stiffened, swelled, blotched, or ulcerated. Soda-water or 
nitric acid, {see Dispensatory,) will be found a useful auxiliary, 
when the disease is inveterate. 

The belly will most frequently be kept open by this medicine; 
and when it is not, the exhibition of cream of tartar, or tamarinds, 
will be highly beneficial. When the gums are enlarged, ulcerated, 
and fetid, the mouth should be frequently washed with a decoction 
of red oak bark, in which a little alum is dissolved, and the gums 
rubbed with a powder composed of equal parts of finely pulverised 
charcoal and bark, with which the scorbutic ulcers may be dressed 
morning and night. These ulcers may be known by their soft and 
spongy edges. 

Regimen. — So uncommonly salutary are vegetables in this disease, 
that whenever they can be had fresh, they should, with ripe fruits 
and milk, constitute the chief part of diet for scorbutic patients. 
When these articles cannot be procured, a mild nourishing diet, with 
wine, cider, and porter, is most proper. As nothing is of more im- 
portance to the scorbutic, than breathing pure fresh air, it should at 
all times be well supplied. Seamen, therefore, affected with it, ought 
constantly to keep on deck in fair weather. 



ERUPTIONS OF THE SKIN. 

There subsists so intimate a relation between the internal and 
external parts of our body, that no disorder scarcely takes place 
within, that does not show itself ultimately on the surface. 

Diseases of the skin are therefore very numerous, and, as they 
most commonly arise from a constitutional cause, should be treated 
by general remedies. 

Local applications, particularly quack remedies, which are com- 
posed of mineral poisons, by repelling the vitiated humours to the 
brain, lungs, or bowels, have often produced fatal consequences. 



332 ERUPTIONS OF THE SKIN. 

Persons of relaxed habits, especially females, are subject to an 
eruption, attended with redness and soreness of the skin, forming 
large spots on the face and neck. This is certainly the mark of a 
constitutional debility, and can only be removed by tonics ; as the 
bark, bitters, solution of arsenic, nitric acid, &c, and exercise. At- 
tention should also be paid to a frequent change of linen, and the 
skin occasionally dusted with starch. 

Cutaneous eruptions oftentimes arise from a foulness of the 
stomach, in which case, occasional vomiting and purging are found 
to be highly useful. 

There are eruptions in the face of persons of apparent health, 
called grog blossoms, which are the consequence of an inflamed 
liver, from a too frequent use of wine and spirits, and high living. 

An attempt to remove these pimples by external means, would 
not only be fruitless, but highly dangerous. Their cure can only be 
effected by gradually correcting the habits of intemperance, both in 
eating and drinking. 

The primary affection must be first relieved. This is to be done 
by taking, every night, from half a grain to one grain of opium, 
combined with two grains of calomel. After using this medicine 
for some time, or until the mouth is affected by salivation, the nitric- 
acid diluted, (see Dispensatory,) in its usual doses, will complete 
the cure. 

Scaly affections of the skin, or clusters of small pimples over the 
body, usually occur, in some habits, in the spring and fall, which 
will generally yield to sassafras tea, or cream of tartar and sulphur, 
in doses of a tea-spoonful, night and morning. Should this fail, the 
decoction of sarsaparilla, and one of the mercurial pills, night and 
morning, for a week or two, and afterwards, the solution of arsenic 
will always succeed. 

The prickly heat, is an eruption which is sometimes very trouble- 
some, but commonly disappears on keeping moderately cool, and 
avoiding warm drinks. When this is not sufficient, and the itching 
is severe, the cathartic mixture taken two or three times a-week, and 
the external applications of elixir vitriol diluted in water, or the itch 
lotion, (see Dispensatory,) with the addition of a little more water, 
will prove a good remedy. 

The nettle rash, so called from its resemblance to eruptions, 
made by the stinging of nettles, is sometimes attended with intoler- 
able itching. When many of the eruptions run together, the part 
seems swelled, forming tumors, such as appear after being struck 
with the lash of a whip, and betwixt them, the skin is inflamed and 
very red. The elevations appear suddenly, but seldom continue 
long, and are apt to disappear from one part of the body, and appear 
again in another. 

The itching is the greatest inconvenience, as it sometimes pre- 
vents the patient from sleeping, but the disease is not dangerous. 

With respect to the cure, observing a cooling regimen and a laxa- 



ITCH — TETTER, OR RING- WORM. 333 

tive state of the bowels, is generally sufficient ; but if fever super- 
vene, it will be proper to bleed and give the antimonial solution in 
small doses, to determine the fluids to the surface. When the dis- 
ease is of a chronic nature, and often returns, twenty drops of elixir 
vitriol, taken thrice a-day, in a cup of camomile or centaury tea, or 
the infusion of Columbo, should be directed. 

To allay the itching, a solution of borax, in vinegar, an ounce of 
the former, to half a pint of the latter, affords a good wash. 



ITCH. 



The itch consists of small watery pimples of a contagious nature, 
which first appear between the fingers, and on the wrists, but in pro- 
cess of time, spread over the whole body, except the face, attended 
with a great degree of itchiness, especially after being heated by ex- 
ercise, or when warm in bed. 

In the cure of this disease, sulphur, used internally and exter- 
nally, is considered as a certain specific. A tea-spoonful of the flour 
of sulphur, taken in milk, or spirits and water, thrice a-day, and 
some of it rubbed on the inside of the arms and legs at bed-time, 
either dry, or in the form of unction, will soon effect a cure. Where 
the sulphur is disliked, the mercurial ointment may be rubbed in 
every night about the size of a nutmeg, until the eruption entirely 
disappears. The itch lotion, (see Dispensatory^) will also be found 
an effectual remedy in this complaint, by washing the parts affected 
with it two or three times a-day. The internal exhibition of sul- 
phur alone, or combined with cream of tartar, should always precede 
or accompany the external applications. Dock-root, tobacco, and 
Virginia snake-root, (see Materia Medica,) have sometimes cured 
when the above remedies failed. 



TETTER, OR RING-WORM. 

Is an eruption that attacks various parts of the skin, in a circle, 
with an inflamed basis, which gradually spreads, forming an exten- 
sive excoriation, sometimes moist, at other times dry, and is attended 
with smarting and itching, succeeded by scurfy scales. 



334 



OR SCALD HEAD. 



Treatment. — If the habit of body be not faulty, external appli- 
cations alone, are often sufficient to remove this affection. 

The saturated solution of borax, with vinegar or lemon juice, one 
drachm to an ounce of the acid, is an excellent remedy, without 
producing the least pain on its application. The itch lotion, when 
prepared with double its strength, is also equally good. Covering 
the^ eruption daily with ink, or the juice of black walnut, (see Ma- 
teria Medico,,) has often affected a cure. 

Where the disease is iuveterate, internal medicines must be ex- 
hibited and continued for some time, such as lime-water, flour of 
sulphur, the mercurial pills, or, which is preferable to all of them in 
obstinate cases, the solution of arsenic. (See Dispensatory.) 

This eruption has been removed by the application of soft soap 
and ginger. 

A valuable remedy will be found in the application of common 
soot and the addition of sufficient lard to make a paste. 

A most inveterate eruption of the tetter sort has been speedily re- 
moved by the application of the following mixture. Take tincture 
of cantharides half a drachm,— nitric acid half an ounce, — of creo- 
sote half a drachm. To be applied to the part. Add the creosote first 
to the acid — then add the tincture of cantharides. The following 
ointment afterwards to be used. Iodide of iron five grains. Creo- 
sote fifteen drops. Stramonium ointment an ounce. 

Where internal remedies have been found necessary, the following 
mixture has proved signally beneficial : Hydriodate of potass two 
drachms. Cinnamon water five ounces. Extract of cicuta one 
scruple. Half a table-spoonful may be taken twice a-day. 

Blood root, steeped in vinegar, and used as a wash, has been 
known to effect cures. 



TINEA, OR SCALD HEAD. 

Symptoms. — This disease consists of little ulcers at the roots of 
the hair, which discharge a humour that dries into a white scab, or 
thick scales, and has an offensive smell. It is not only a very trou- 
blesome complaint, but contagious, and, when united with a scrofu- 
lous constitution, is found extremely difficult to be cured. 

Treatment. — When it is merely a complaint of the skin, it may- 
be successfully treated with topical applications. In the beginning 
of the affection, washing the sores well, night and morning, with 
strong soap-suds, or a decoction of tobacco, or by applying an oint- 
ment, made of jimson-weed, or pride of China, (see Materia Me- 
dica,) will frequently effect a cure. But if the disorder prove obsti- 
nate, the head ought to be shaved ; and after being well washed 



SCROFULA, OR KING'S EVIL. 335 

with soap-suds, covered with tar and suet, spread on a bladder. My 
very ingenious friend, Dr. Chapman, has assured me, when every 
other application failed in removing this disease, he always succeeded, 
by having the affected parts washed with the following lotion, twice 
a-day : — Take liver of sulphur, three drachms ; Spanish soap, one 
drachm ; lime-water, eight ounces ; rectified spirits of wine, two 
drachms : mix. 

But, in cases where topical applications are resisted, medicine 
should be given internally, as lime-water, flour of sulphur, or calo- 
mel, according to circumstances ; and, to hasten the cure, the course 
of the fluids may, in the mean time, be in part diverted from the 
head, by blisters or sinapisms. 

When every thing else has failed, the following ointment has been 
crowned with success. Of the ashes of tobacco — green grape vine 
and green elder, of each a table-spoon full. Hog's lard an ounce. 
Tar an ounce. Flowers of sulphur half an ounce. Poke root and 
burdock root, of each two ounces. Sumach berries two ounces. 
Beat them together with half a pint of sweet oil and a gill of spirits 
of turpentine. Then simmer them over the fire and use as an oint- 
ment. Shave the head and put on a night-cap greased with this 
ointment. Wash the head every other day with Castile soap and 
renew the ointment. The following remedy will also be found 
useful. Of red precipitate half a drachm. Venice turpentine a 
drachm. Fresh butter an ounce. Make an ointment and apply. 
An excellent application is an ointment made of the black-alder, and 
drink freely a tea made of the same. Another valuable remedy in 
obstinate cases is the following : — Take two handfuls of the soot of 
wood. Pure water one pint. Boil for half an hour. After each 
lotion apply an ointment made of lard four ounces, and soot enough 
to make of the consistence of an ointment. A remedy highly praised 
is strong tan-water, with which the part is to be bathed. 



SCROFULA, OR KING'S EVIL. 

This disease is most frequent among the children of the poor, 
and negroes, who are ill-fed, ill-lodged and ill -clothed; it is also 
hereditary, but never contagious. It most commonly occurs in 
children from the third to the seventh year ; frequently, however, it 
discovers itself at a later period in habits peculiarly disposed to it. 

Symptoms. — It is known by indolent hard tumours of the lym- 
phatic gland, particularly those of the neck, behind the ears, or under 
the chin. The upper lip, and division of the nostrils are swelled, 
with a smooth skin, and hard belly. In the progress of the disease, 



336 JAUNDICE. 

these tumors degenerate into ulcers of bad digestion ; the discharge 
of which consists of a white curdled matter, resembling somewhat 
the coagulum of milk; and, previously to their breaking, they ac- 
quire a sort of purple redness, and a softness to the touch. 

Treatment. — As soon as the tumors are first discovered, endea- 
vour to disperse them by sea bathing, or bathing in salt and water, 
one pound to three gallons of water, or cold water alone, or by the 
frequent application of lead-water. Warm fomentations and poul- 
tices of every kind do harm, as they seem only to hurry on a suppu- 
ration, which, if possible, should be prevented. A draught of sea 
water every morning is a useful drink. Peruvian bark and steel, 
used alternately every two weeks, or the nitric acid, will be of infi- 
nite service by giving tone to the system. The remedy, however, 
most to be depended upon in this disease, is the muriate of lime, 
given in doses of ten to eighty drops, gradually increased, three or 
four times a-day, diluted with water or tea. When a suppuration 
takes place, the solution of arsenic should be given twice or thrice 
a-day. The best application to scrofulous ulcers, is a powder com- 
posed of one pound of finely powdered bark, and one ounce of white 
lead in fine powder, mixed well together, or a fine powder of cala- 
mine stone alone, and the ulcers covered with it daily, keeping it on 
by brown paper and a bandage. Where these are not to be obtained, 
the constant application of linen rags, moistened with a solution 
of one ounce of sugar of lead, in a pint of water, may answer every 
purpose. 

With respect to the diet, it should be nourishing and easily diges- 
ted, and avoiding all viscid food. Moderate exercise, in a dry warm 
air, is exceedingly beneficial. 



JAUNDICE. 



Symptoms. — Yellowness of the skin, but chiefly of the eyes, the 
urine is also yellow ; inactivity ; anxiety and uneasiness at the pit of 
the stomach ; itchiness of the skin. 

Causes. — Whatever obstructs the passage of the bile, through its 
natural channel. 

Treatment. — The indications of cure are, to remove the ob- 
structions, which, as it originates from different causes, will require 
different modes of treatment. 

As viscid bile is the most common cause of this complaint, in full 
habits, and where there are any feverish symptoms, begin the cure 
with bleeding, afterwards give an emetic, and then a day after, a 
dose of calomel and jalap, which, if necessary, should be often re- 






WHITE SWELLING. 337 

peated. Common soap, in large quantities, has been exhibited with 
much success in this case; but, as this is disagreeable to take, the 
salt of tartar, which has the same advantage, or soda, may be 
taken in doses of twenty or thirty grains, three or four times a-day, 
dissolved in the infusion of Columbo. 

If there be any acute pain in the region of the liver, with a quick- 
ness of the pulse, bleed more freely, give one of the mercurial pills, 
(see Dispensatory,) night and morning, until a ptyalism be produced, 
use the warm bath, and apply a blister over the pained part. In 
cases of much pain, three or four table-spoonsful of olive oil should 
be swallowed; and, if it do not succeed in quieting the pain, one or 
two tea-spoonsful of ether, or thirty drops of laudanum must be 
given. The warm bath, or bags of hot salt applied to the right side, 
are likewise beneficial. After the obstruction is removed, the Co- 
lumbo or nitric acid, tonic powders or pills, or dog- wood, or cherry- 
tree bark, (see Materia Medica,) with porter and wine, are necessary 
to restore the tone of the system. 

Regimen. — The diet ought to be regulated according to the con- 
stitution of the patient. In plethoric or feverish habits, the diet 
should be low ; and in cases of excessive debility it should be of the 
most nourishing kind. Vegetables, by creating flatulency and acidity, 
are to be avoided. Mucilaginous drinks are peculiarly proper ; and, 
in many instances, sucking a new-laid egg every morning, on an 
empty stomach, has succeeded in curing this disease, when all other 
means failed. 



WHITE S WELLING 

Is distinguished by an acute pain, without any external inflamma- 
tion, of a joint, attended with a gradual increase of its size. Though 
all the joints are occasionally subject to it, yet its most usual seat is 
the knee. 

White swellings are generally of a scrofulous nature, but some- 
times they are produced by rheumatic affections, and sometimes 
follow strains that have been neglected, or badly treated. 

Treatment. — As soon as an affection of this kind is discovered, 
the patient should remain in bed, and the limb kept perfectly at rest, 
without which, remedies cannot produce any good effect. 

The great object is to prevent the formation of matter, by the im- 
mediate application of leeches, or scarifications to the part affected, 
and by which, eight or ten ounces of blood may be taken away, every 
other day, or oftener, according to circumstances. The whole joint 
43 



338 



SEA SICKNESS. 



should then be kept continually wet and cold with the solution of 
crude sal-ammoniac, (see Dispensatory,) by means of four or five 
folds of linen. After the local affection is somewhat abated, frictions 
with the volatile liniment, or a mixture of soft soap and spirits of 
camphor, to which may be added some tincture of cantharides, will 
have a good effect. With one or other of these liniments, the joint 
is to be rubbed well twice a-day, and afterwards covered with a piece 
of flannel that has been soaked in the same. If this should not pro- 
duce good effects, the part must be rubbed night and morning with 
mercurial ointment, in the quantity of two drachms at a time, and 
continued until the mouth be gently affected. The cure may then 
be completed by small blisters on each side of the joint, which should 
be kept running for a length of time. 

If the disease in spite of these remedies continue to advance, emol- 
lient poultices must be applied often, until various abscesses appear, 
and these should be opened as soon as they seem to point, afterwards 
to be treated as ulcers. 

In cases where the white swelling is evidently scrofulous, tonic 
medicines, as bark, steel, &c, and a nourishing diet, to correct the 
constitutional affection, with stimulating applications to the joint, 
form the best remedies. 



SEA SICKNESS. 

Symptoms. — A most unpleasant giddiness, with great nausea and 
vomiting, occasioned by the motion of the vessel. The duration of 
this complaint is veiy uncertain. Generally, it lasts but a day or 
two, but in some cases it will continue a whole voyage. 

Treatment. — Though time, perhaps, be the only cure, yet it 
will be greatly alleviated by keeping the bowels open. A tea- 
spoonful of ether, in a glass of water, relieves the convulsive af- 
fection of the stomach. High-seasoned food, and acidulated drinks, 
are peculiarly proper. But nothing will be found more serviceable 
than exercise, cheerfulness, and fresh air. Persons should, therefore, 
never go below, but romp on the decks, cut capers in the shrouds, 
and divert their minds and move their bodies as much as possible. 






INTOXICATION. 339 



INTOXICATION. 

Symptoms. — Like every other kind of frenzy, it comes on with a 
burning redness of the cheeks ; a swelling of the jugular veins, and 
fiery wildness of the eyes. The tongue is considerably affected, but 
very differently in different stages of the disease. At first, only glib 
and voluble — then loud and louder still — at length noisy and exces- 
sively disagreeable. The patient is now quite on his top-ropes, and 
nothing goes down with him, but the most ranting songs, roaring 
laughs, ripping oaths, and the bluntest contradictions, accompanied 
with loud thumping of the fist on the table, especially if politics be 
the topic of conversation. There is no complaint that affects patients 
so differently: some it makes so ridiculously loving, as to hug and 
kiss one another ; others it kindles into such rage and fury, that they 
will frequently throw the bottles and glasses at the heads of their 
best friends. And, indeed, so wonderful is its influence, that it is 
no uncommon thing with it to inspire cowards with courage ; to teach 
truth to liars, and to make persons naturally reserved, loquacious, 
and even boisterous. 

The memory now partakes of the general infirmity, being hardly 
able to connect the parts of a story begun. The tongue, at length, 
as if about to lose its powers, begins to trip ; then to stammer ; and, 
at last, the utterance dies away, generally, in some idle half finished 
threat or oath. Hiccoughs now ensue, with a silly grin of the mouth, 
which continues half open, from the falling of the lower jaw. The 
face puts on an air of great stupidity — the eyes turn heavy and 
sleepy, and the patient begins to nod, with his head bending for- 
ward, until, becoming too heavy, he sinks under the table, and 
not unfrequently, after a filthy vomiting, falls asleep among the 
dogs and cats. 

Treatment. — In a fit of drunkenness, the patient should instantly 
be placed in an airy situation, the head and shoulders kept erect, 
and the neck cloth and collar of the shirt unbound, and copiously 
bled, if his situation seem alarming. The next step is to provoke 
vomiting, by the most expeditious means, such as tickling the throat 
with a feather or the finger. Cold applications to the head, as cloths 
wrung out of cold water, or vinegar and water, often renewed, will 
have the happiest effect; so will plunging the body in cold water; 
for many instances have occurred of persons having fallen overboard 
in a drunken fit, who have been picked up sober. 

Therefore, it will be found an admirable mode of sobering those 
vagabonds, who, as a nuisance, infest the streets of every city, to take 
them to the nearest pump, and there deluge them with cold water 
This will not only bring them to their senses, but send them off, 
under that sense of shame, which ever follows the commission of a 
crime so truly ignominious. 



340 TO RECOVER PERSONS APPARENTLY DEAD. 

TO RECOVER PERSONS 
APPARENTLY DROWNED. 

As soon as the body is taken out of the water, it should instantly 
be rubbed dry, and wrapt in warm blankets, unless the cooling pro- 
cess should be first necessary, in consequence of the patient being in 
a half frozen state. For, in that case, the body ought to be rubbed 
with snow, or flannels wrung out of cold water or vinegar, before 
any degree of artificial warmth be applied. After which, the patient 
is to be placed on a bed or mattress, with the head elevated, and air 
is then instantly to be blown into the lungs, by inserting the pipe of 
a pair of bellows into one nostril ; or, for want of that article, a to- 
bacco pipe, a quill, or even a card folded in the form of a tube, while 
the mouth and opposite nostril are closed by an assistant, or covered 
with some wet paper. By thus forcing air into the lungs, and alter- 
nately expelling it by pressing the chest, respiration may happily be 
restored. Volatile salts, or vinegar, should also frequently be applied 
to the nostrils. 

Next the intestines are to be stimulated by injections of warm 
spirits and water, or mulled wine. It will be more effectual still, if 
some warm spirits and water be introduced immediately into the 
stomach, by means of a syringe and a long flexible tube. While 
using the internal stimulants, a bladder of warm water should be ap- 
plied to the region of the stomach, and the legs and arms briskly 
rubbed with a warm hand, or with flannel, extending the friction 
gradually to the thighs, belly, and chest. 

At that critical period, when sneezing, slight twitchings, or gasp- 
ing, mark the first dawn of returning life, it will be prudent to mo- 
derate the stimulating powers. When respiration and the power of 
swallowing are restored, the patient should be kept moderately warm, 
and gentle perspiration encouraged by warm drinks. 

Should feverish symptoms ensue, moderate bleeding, together 
with mild laxatives and cooling regimen, will complete the cure. 



TO RECOVER PERSONS 

Apparently killed by Lightning, or noxious Vapours. 

Treatment. — Instantly throw cold water, with some force, in 
large quantities, on the face and head, which should be often re- 
peated for some time; and, if convenient, the whole body may be 



TO RECOVER PERSONS APPARENTLY DEAD. 341 

plunged into cold water, and afterwards wiped dry, and warmth 
gradually applied. If the body and the extremities feel cold, instead 
of the application of cold water, the warm bath, about the tempera- 
ture of the blood, should be prepared as soon as possible, and the 
patient immersed in it for twenty or thirty minutes, using frictions 
at the same time with the hand. As soon as the patient is taken 
out of the bath, his skin must be wiped dry, and wrapped up in 
warm flannel, and gentle stimulants employed to produce a reaction. 

The vital principle is not unfrequently suspended by the delete- 
rious fumes arising from fermenting liquors, from charcoal, coke, 
&c; from combustion, from metals in a state of fusion, particularly 
arsenic and mercury; as, also, very often, from respiring the foul air 
of wells, privies, caverns, and mines. In such cases, the person 
should be freely exposed to pure and cool air, and supported, at the 
same time, in a leaning posture. Volatile salts, or other stimulating 
substances, are then to be applied to the nose, and cold water made 
use of, as above directed. When by these means the circulation of 
the blood is increased, and the extremities become warm, bleeding 
will be proper, and must be often repeated, if the patient have fever, 
or complain of pain. Besides which, evacuations must be procured 
by purgative medicines and clysters ; and the antiphlogistic plan in 
every respect strictly pursued, until the febrile symptoms abate. Af- 
ter which, tonic medicines, with wine, in case of debility, are of infi- 
nite service. 

In places where a lighted candle will not bum, animal life cannot 
be supported ; and, therefore, in all cases, where wells, cist-pools, or 
deep vaults, are to be opened, a large candle, lighted, ought to be 
let down very slowly to the bottom, before any person attempt to 
descend. 

If the candle be extinguished, means must be adopted to remove 
the noxious air, before any one descend. To effect this, the follow- 
ing modes will answer : 1st. Let the leather pipe of an engine be 
introduced to the bottom of the well, if empty, or the surface of the 
water, and affix a blacksmith's bellows to the other end, when, by 
well working this, the foul air may be expelled. 2dly. Carbonic 
acid gas may be bailed out with a bucket made of coarse cloth like 
a bag, with a round piece of board, nearly the diameter of the well 
at the bottom ; let the bucket, thus made, down upon the water, so 
that the bottom may rest upon it, and let the bag fall upon the bot- 
tom ; then draw it up, when it will be filled with foul air, which 
may be brought up to the surface, and emptied by turning out and 
shaking the bag. 3dly. Let down about a bushel of quick-lime, 
dipping it into the water occasionally, to slack it ; or, if there be no 
water in the well, throw down some for the purpose. 4thly. Pour 
down a large quantity of boiling water repeatedly into the well. 



342 POISON — BITES OF MOSCHETOES. 



POISON. 

Treatment. — The cure of poisons swallowed, whether vegeta- 
ble or mineral, requires an immediate evacuation, or a counteraction 
of their effects. Therefore, as soon as possible, throw in an eme- 
tic, quick in its operation, as blue or white vitriol, in a dose, from 
five to twenty grains, repeated in fifteen minutes, if necessary, and 
assisted by copious draughts of warm water. 

To remove the stupefaction which generally ensues after an im- 
prudent dose of opium, acids of the vegetable class, as lime juice, or 
vinegar diluted with water, ought to be exhibited freely. But if the 
patient lay in a deadly stupor, with cold extremities, the warm stim- 
ulating plan must be first adopted. Sinapisms or blisters ought in- 
stantly to be applied to the extremities ; or, as a more effectual re- 
medy to produce reaction in the system, the legs and arms should 
be whipped well with rods, and the soles of the feet seared with a 
red hot iron. 

It appears, from incontestable experiments, that the white of an 
egg beaten up with cold water is the best antidote against corrosive 
sublimate and the other mercurial preparations. The whites of 
twelve or fifteen eggs, are directed to be beaten up and mixed with 
two pints of cold water, and a glass full taken every two or three 
minutes, so as to favour vomiting. In defect of eggs, milk and mu- 
cilaginous drinks may be used with great success. The same me- 
thod may be pursued, in case arsenic or any other metallic salt has 
been taken. A drink, composed of equal parts of lime-water and 
sugar and water, should also be given when arsenic has been swal- 
lowed. Unless these remedies be quickly resorted to, death will in- 
evitably take place. Should fever supervene, the antiphlogistic 
treatment must be pursued. The application of tobacco will assist 
the operation of an emetic. (See Materia Medica.) For the poi- 
sonous effects of lead, see Vine. 



BITES OF MOSCHETOES. 

Moscheto bites often degenerate into painful acrid ulcers, partic- 
ularly on the legs, in consequence of scratching them. It is, there- 
fore, proper, where these insects are troublesome, to wear loose linen 
buskins to guard the legs in the evening ; and when this has been 
neglected, apply oil, vinegar, lime juice, or camphorated spirits, to 
the part, to allay the itching and tingling occasioned by their bites. 



BITES OF VENOMOUS ANIMALS. 343 



BITES OF VENOMOUS ANIMALS. 

Treatment. — The bites of all venomous animals are cured by 
the same means, which are very simple, if the remedies were al- 
ways at hand. The caustic volatile alkali, or eau de luce, is a cer- 
tain antidote against the bites or stings of the most venomous serpents 
or spiders. Lint wetted with either of these should instantly be ap- 
plied to the injured part, and renewed as it becomes dry. A tea- 
spoonful of the same medicine must also be given to the patient in 
a little water, every hour, or oftener, as may be indicated by the 
symptoms. 

Lunar caustic possesses the same admirable virtue, and should al- 
ways be employed, when the other medicines are not at hand. The 
best mode of using it, is to dissolve five or six grains of the caustic 
in two or three ounces of water, and keep the affected parts mois- 
tened with it, as above directed. Some of the same ought also to be 
given internally, only in a more diluted state. When these reme- 
dies cannot be procured, a cataplasm, made of quick-lime and soap, 
should be applied to the bitten part, and as much Cayenne, or red 
pepper, mixed in spirits, swallowed every hour or two, as the sto- 
mach can possibly bear. 

The juice of plantain and hoar-hound, in doses of a table-spoonful 
every hour or two, is considered a good remedy against the bites of 
venomous serpents, as is also squirrel ear. (See Materia Medica.) 

As soon as the person is bitten by a poisonous animal, a tight liga- 
ture should be made above the injured part, until suitable remedies 
can be employed. When the toe or finger is bitten, cutting it off 
immediately will prevent mischief from the poison. 

It is also a fact that sucking the wound, immediately after being 
bitten, will arrest the progress of the poison. This was lately verified 
in the neighbourhood of Augusta, in the case of a youth who was 
bitten by a rattle-snake, and the wound being instantly sucked by a 
man present, prevented its mischievous effects; nor did any injury 
result to the operator. 

When this remedy is resorted to, it may be prudent for the opera- 
tor to guard his mouth with sweet oil or milk, and not swallow the 
saliva. It should never be attempted by a person with a sore mouth 
or very bad teeth. 



344 HYDROPHOBIA—GUINEA WORM. 



HYDROPHOBIA, 



OR THE BITE OF A MAD DOG. 

This disease is so dreadfully alarming at all times, that we ought, 
as the best means of security, to endeavour to prevent it. 

Therefore, as the infection of a rabid animal is conveyed by his 
teeth into the wound, the sooner it be removed, the less chance is 
there for absorption. Consequently, the bitten part should immedi- 
ately be washed ; and, where it can be cut out, this should be done 
deeper and more extensively, than the wound itself. Then apply a 
cupping-glass, with previous scarification, and cauterize the wound 
with lunar caustic. If the wounded part cannot be excised from its 
situation, it must be well washed, and then scarified, and a free dis- 
charge of blood promoted by a cupping-glass. This being done, 
the bitten part is to be well cauterized with caustic, and a proper 
discharge kept up for a considerable time. 

In addition to this treatment, we should diligently employ mer- 
cury, both internally and externally, to excite a salivation. Opium, 
in such doses as are given in tetany, has been said to produce bene- 
ficial effects. 

A strong solution of arsenic, in water, has been recommended as 
an excellent wash for wounds inflicted by rabid animals; this having 
been found to possess the power of destroying the poison, and thereby 
preventing hydrophobia from taking place. 

It is probable, the caustic volatile alkali, might prove an antidote 
against either the poison of a rabid animal, or that of the most veno- 
mous serpents. 

The scull-cap, chick-weed, and emetic weed, {see Materia Medi- 
cal) are considered valuable remedies in this dreadful disease. The 
most certain remedy, however is to cut out the part ; and this is 
certain at any period previously to the inflammation. If the wound 
be inflicted so deeply that the bitten part cannot be separated, a 
caustic must be applied to what remains. 



GUINEA WORM 

This disease is frequent among the new negroes, and is pretty 
uniform in its appearance. 

The patient is at first sensible of an itching, and on examining the 
part, a small blister is generally to be perceived. — Frequently, two 



SWALLOWING OP PINS. 345 

or three of these blisters manifest themselves ; and at times the part 
has the appearance of being stung with nettles. Beneath these 
blisters, or other affections, on raising the skin, there appears a small 
piece of mucus, on removing which, the head of a worm is to be 
seen. It is generally firmly fixed, and requires force to detach it 
from the parts beneath. When once separated with the forceps, it 
can be twisted round a ligature, or a piece of lint, and by this means, 
a portion of it, a foot or two in length, may be extracted in the 
course of one day. 

In its appearance, it resembles what is called bobbin, or small tape, 
and is of the same size. It is transparent and moist, and appears to 
contain something like a white liquid. As much of it as will come 
away without pulling, is daily to be extracted. It is always danger- 
ous to use force, on account of the risk of breaking the worm. 
When this accident happens, it occasions the most acute pain, ac- 
companied with swelling and inflammation of the neighbouring 
parts; and these symptoms will often continue for two or three 
weeks. In this case, the worm also takes a different course, and 
soon throws itself into another part. 



SWALLOWING OF PINS. 

Pins, and other hard and sharp-pointed substances, sometimes pass 
into the gullet, and even into the stomach. It is too prevalent a 
practice, when any substance of this kind has passed into the stomach, 
to endeavour to hasten its passage through the bowels, by giving 
some opening medicine. 

Milk alone, or mixed with raw eggs, should be immediately taken, 
as by the coagulation which takes place, the substance may become 
so involved, as to prevent its doing injury to the stomach ; and on 
the same principle, should opening medicines, which render the 
faeces thin, be avoided ; as by allowing the faeces to obtain some 
firmness, there will be the greater probability of the pointed parts of 
the substance being so sheathed, as to prevent their injuring the in- 
testines. It is but rare, however, that any serious injury is done to 
to the stomach by the point of the pin. 

44 



346 CHILBLAINS — SCALDS AND BURNS. 



CHILBLAINS. 

Symptoms. — A number of inflammatory swellings, chiefly affect 
ing the heels, feet, and toes, and sometimes the arms and hands, 
attended with a degree of pain and excessive itching. 

Causes. — This disease is owing to a weaker action of the small 
vessels most remote from the heart, occasioned by cold or dampness ; 
and occurs most frequently among children, and people of delicate 
constitutions. 

Prevention. — Where the parts are frost bitten by long exposure 
to the cold, they should be plunged into the coldest water, and af- 
terwards rubbed with salt. When they are only benumbed, they 
may be rubbed with strong brine, or spirit of camphor, or opodeldoc, 
(see Dispensatory^) to which, a little laudanum may be added, if 
the pain or itching be very troublesome ; but when they crack and 
discharge an acrid matter, poultices should be applied, but not for 
any length of time, as their continuance is apt to produce fungous 
excrescences. — The application of diachylon plaster to the part, if 
the exciting cause be avoided, will afterwards effect a cure. 



SCALDS AND BURNS. 

The leading indication in affections of this kind, is to abate the 
pain ; and this is effected by whatever induces insensibility of the 
part, as plunging it suddenly into cold water, covering it with ice 
or snow, or applying soft soap, brandy, laudanum, ether, or spirits 
of turpentine. Of these remedies, spirits of turpentine deserves the 
preference, especially where the skin is detached. A liniment pre- 
pared of basilicon ointment and spirits of turpentine, and applied 
twice a-day to burns, when there is a loss of substance, alleviates 
the pain like a charm, and brings the sore to suppuration in a few 
days, which may afterwards be healed, by a liniment composed of 
equal parts of linseed oil and lime-water, or by the application of the 
simple saturine ointment, or Turner's cerate, (see Dispensatory^) 
or, what is preferable, an ointment made with thorn apple. (See 
Materia Medica.) 

The application of cotton to a burn or scald, admirably alleviates 
the pain. My honourable and highly esteemed friend, Dr. James 
Jones, of Virginia, stated to me the case of a child which fell into a 



HERNIA, OR RUPTURES. 347 

tub of scalding water, being most wonderfully relieved of pain, im- 
mediately on covering it with carded cotton. After a few days, he 
directed the sores to be dressed with the thorn apple ointment, which 
soon completed the cure. 

Blisters, which occur from burns, should be opened as soon as the 
irritation induced has subsided ; and in order to prevent any bad ef- 
fects from the admission of air, small punctures ought to be made, 
in preference to incisions. 

When fevers attend burns, mild laxatives become necessary ; and 
where the pain is violent, laudanum ought to be given in pretty 
large doses. Should the sores not heal kindly, astringent washes are 
necessary, as recommended for indolent ulcers. 



HERNIA, OR RUPTURES. 

The term rupture, was adopted when it was supposed that the 
disease was always the consequence of a rupture of some of the 
parts, which form the cavity of the abdomen or belly. But anato- 
mical examination has shown, that this disease, as it most commonly 
appears, takes place in consequence of the protrusion of some of the 
contents of the abdomen through openings, which are natural to the 
human body, and without any violent separation of the parts. It 
will not be necessary to describe, particularly the several kinds of 
ruptures which may occur. It will be sufficient to observe, that 
ruptures will generally appear in the groin, in the upper and fore 
part of the thigh, and at the navel. Those which appear, at first 
just above the groin, will, in general, if neglected, soon descend into 
the scrotum, in men, and into the labia pudendi, of women. The 
tumour, in this disease, is most commonly formed by a part of the 
intestinal canal, or of the omentum or caul, or of both. 

In those ruptures which are capable of easy reduction, as soon as 
a pressure is properly made, the protruded intestine generally slips 
up, all at once, with a kind of gurgling noise, and the tumour im- 
mediately subsides; where the tumour has chiefly been formed by 
the omentum, it passes up more slowly, and without that particular 
noise which accompanies the return of the intestine. 

In those cases of rupture, where stricture has taken place on the 
protruded parts, and the reduction is thereby rendered difficult, the 
belly becomes tense and painful, the pain of the belly, as well as of 
the tumour itself, being much increased on the least exertion, a total 
stoppage of discharge by stool takes place, and the patient is dis- 
tressed by a sickness at the stomach, which increases until there is 
almost constant retching and vomiting. 



348 HERNIA, OR RUPTURES. 

To prevent these evils, it is only necessary that such a pressure be 
kept on the opening through which the part protruded, as may pre- 
vent its again falling out. The pressure of the fingers shows how 
effectually this may be done ; and if, at the time this pressure is 
made, the patient but gently coughs, he will discover how forcibly 
the protruding parts are driven outwards, and how necessary it is to 
guard against their future propulsion. The ingenuity of artists has 
devised a mode, by spring trusses, of applying a constant and pro- 
perly adapted pressure, requiring little or no exertion, or even atten- 
tion, of the patient himself. No person, therefore, in the situation 
just described, should suffer a day to pass, more than is absolutely 
unavoidable, without obtaining the comfort and security which will 
follow the application of a truss, since, if it be adopted at the first 
appearance of the disease, not only will the malady be stopped in its 
progress, but, if employed with constancy and steadiness, a radical 
cure may be gained. 

If it be discovered that the return of the rupture is become diffi- 
cult, and that a stricture on the protruded part has perhaps taken 
place, the person should place himself on his back, inclining to the 
side opposite to that diseased, with the head low, and the breech 
raised high, the knees being drawn upwards, and a little outwards. 
Whilst lying in this posture, he should endeavour, by such pressure 
as he has been accustomed to employ for its reduction, to return the 
protruded part. Should he not succeed in this attempt, he may lay 
on the part a piece of folded linen, dipped in cold water, and repeat 
his attempts. If these be also unsuccessful, he may then be assured 
that a stricture has taken place, and as his life depends on its speedy 
removal, no time should be lost in obtaining the best surgical assis- 
tance that can be had. 

The umbilical hernia, or the rupture of the navel, is most common 
in childhood, and is easily cured, if early attended to. 

The means to be adopted are simply these : — the protruded parts 
are to be returned, which may be easily done, by slight pressure 
with the finger, and retained in their proper situation, by a conical 
piece of very soft sponge, thoroughly cleared, by rubbing between 
the thumb and finger, of sand and minute shells, which may be 
lodged in its cavities. This being kept to the part, by the point of 
one finger, is to be secured by several slips of strongly adhesive 
plaster, three inches in length, crossing each other in a stellated form. 



PROLAPSUS ANI WARTS AND CORNS. 349 

PROLAPSUS ANI, 

OR FALLING OF THE FUNDAMENT. 

It is occasioned by weakness of the part, which is aggravated by 
costiveness, hemorrhoidal swellings, diarrhoeas, and particularly a 
tenesmus. 

Treatment. — The cure is to be effected by reduction of the part 
as soon as possible, and retaining it in its natural position, by a com- 
press, secured with a bandage. To effect its reduction, the patient 
should be laid on his face in bed, with his buttocks raised above the 
rest of his body, and while supporting the tumour with the palm of 
one hand, the gut least protruded, is to be first introduced with the 
fore finger of the other. As soon as the bowels are returned, the 
bandage is to be applied. When the protruded parts become in- 
flamed, from being exposed to the air, before a reduction be attempt- 
ed, the inflammation is to be alleviated by blood-letting, and foment- 
ing the part with a warm decoction of mullein. 

Persons who are subject to falling of the fundament, would do 
well to wash the part, immediately after evacuation, with a strong 
decoction of oak bark. 

Such remedies as tend to recover the tone of the parts most rea- 
dily, are to be used, as cold bathing partially applied, and injections 
of the decoction of bark, with the addition of a little laudanum, or 
starch, if there be an acrid discharge. With the same view, tonic 
medicines, as steel, Columbo, or bark, should be taken thrice a-day. 
Persons subject to this disease, ought to use such diet as produces 
but little excrements, and those of a soft consistence. Rye mush 
and molasses, used exclusively as a diet for a few weeks, has been 
found to produce a perfect cure. 



WARTS AND CORNS. 

When warts are attended with inconvenience, they may be re- 
moved either by ligature or caustic, according to the extent of their 
base. The caustics commonly used for this purpose, are crude sal- 
ammoniac, blue vitriol, lunar caustic, or tincture of steel, applied 
every day. 

As corns are formed entirely from pressure, we must carefully 
avoid the occasional causes, by wearing wide shoes; and, for then 
removal, they, should be bathed for some time in warm water, and 



350 WHITLOW— TUMOURS, OR BILES. 

then pared off as much as possible, without giving- pain ; after which, 
apply over them a wafer or diachylon plaster, to defend them from 
the cold air. Another method is to allow them to grow to some 
length, through a piece of perforated leather, properly secured by 
plaster, or any other means ; and afterwards, to pick them out, or to 
cut round their root, by which they may, for the most part, be easily 
turned out. 



WHITLOW 

Is an inflammatory swelling of the fingers, confined generally to 
the last joint, particularly under the nail, attended with a sense of 
most burning heat. 

Causes. — It is often induced by external violence, as the punc- 
ture of a pin, or contusion of the nail ; but it most frequently takes 
place without any obvious cause. 

Treatment. — The moment that a sense of any preternatural 
heat, or pain is felt, in order to effect resolution, apply a blister, or 
let the finger be bathed, several times a -day, in a mixture composed 
of four ounces of spirits of camphor, half an ounce of laudanum, and 
two drachms of extract of lead. When these articles are not at 
hand, holding the hand in brandy or sharp vinegar, or very hot wa- 
ter, often repeated, and continued for some time, will likewise pre- 
vent suppuration. According to my honourable and worthy friend, 
John Taliaferro, Esq., of Virginia, the application of a plaster, com- 
posed of lime and soft soap, is a sovereign remedy. 

Should, however, these means fail to produce resolution, the best 
method is to make an early opening down to the bone, which will 
occasion the patient much less pain, than allowing the matter gradu- 
ally to make its own way to the surface; which, likewise, from the 
length of time required, is attended with more mischief to the parts. 
The wound is then to be brought to suppuration by emollient poul- 
tices, and, afterwards, treated as an ulcer. 



TUMOURS, OR BILES. 

Every tumour terminates in one of the following ways : — By an 
absorption of the substance into the circulation, by a conversion into 
pus, or degenerating into scirrhus or cancer. 



TUMOURS, OR ULCERS. 351 

There are two plans for the treatment of tumours. Either by- 
resolution or maturation. In the first, there is a dispersion of the 
swelling; and in the second, it is brought to maturity, and of course, 
a discharge takes place by spontaneous rupture, or by incision. 

Treatment. — In the treatment of tumours, we must be regulated 
by the nature and condition of them. 

If, for example, they should appear on any part of the body, with 
only a slight degree of pain, tension, and inflammation, and no pre- 
ceding indisposition, that may induce us to believe it to be the effort 
of nature to get rid of some noxious matter, we should then endea- 
vour to disperse the inflammation, by strictly observing a cooling 
regimen, by bleeding, by mild cathartics, and by topical remedies, 
as cloths wrung out of lead-water, or saturine poultices, (see Dispen- 
satory,) often renewed. 

But when they arise from bad habits of body, their suppuration in 
all cases should be promoted as soon as possible, by warm emollient 
poultices, as milk and bread, flax-seed, or mush and fat, renewed 
every three or four hours. 

When the suppuration is complete, if the matter do not make its 
own way, the tumour is to be opened with a lancet or caustic, and 
after applying one or two poultices, it should be dressed with basili- 
con, (see Dispensatory,) spread very thin on lint, night and morn- 
ing, until it ceases to discharge ; after which, with Turner's cerate, 
or some healing ointment. If fungous or proud flesh appear, it must 
be destroyed by sprinkling red precipitate, burnt alum, or rhubarb 
over it, or touch the protuberant part with blue vitriol or caustic. 

Attention must also be paid to the general state of the system, 
since, if that particular state on which the tumours depend be not 
changed, the patient may be harassed a considerable time by their 
recurrence. 

Hence, in debilitated constitutions, the tonic and strengthening 
remedies, such as bark, sea bathing, &c, should be employed, and 
in robust and gross habits, sulphur, and cream of tartar, ought to be 
taken in doses of a tea-spoonful thrice a-day. 

A tumour on the gums is to be brought to suppuration, by apply- 
ing roasted figs internally to the part, as warm as can be borne ; and 
afterwards, the mouth is to be frequently w T ashed, either with the 
astringent or detergent gargle. (See Dispensatory.) But when it 
arises from a carious tooth, a removal of it becomes necessary, in 
order to effect a cure. 



352 SCIRRHUS, OR CANCER. 



SCIRRHUS, OR CANCER. 

A cancer is a spreading sore, preceded by a hard or scirrhous 
swelling of the part, attended with pain, and, for the most part, a 
thin fetid discharge. Any part of the body may be the seat of this 
disorder, though it is mostly confined to the glands. 

A scirrhus in the breast commences with a small, hard, and move- 
able kernel, like a pea, without discoloration and without pain. 
This generally increases in size and in hardness. The neighbouring 
parts become affected with a sense of pain and uncommon heat, as 
if touched with fire, or pierced with sharp needles. Inflammation 
now succeeds, which ending in an ulcer or open sore, the cancerous 
state begins. — When the surface of the skin is attacked by cancer, 
it generally begins with a small excrescence of the wateiy kind, 
which becomes a cancerous ulcer, on suffering even the slightest 
irritation. 

Treatment. — If the unfortunate subject of this malady be a 
young person, and of a good constitution, and the complaint in its 
worst state, the best advice to be given is to apply to some experi- 
enced surgeon, and have the part extirpated immediately. When 
extirpation cannot be accomplished, every attempt should be made 
to stop the progress of the complaint, by general and topical blood- 
letting, by a cooling diet, consisting principally of milk and vegeta- 
bles, and to keep the bowels open by the occasional use of mild 
cathartics. 

In the incipient scirrhous state, wearing a hare or rabbit skin over 
the part affected, is extremely useful ; and when this cannot be pro- 
cured, a mercurial plaster will be found serviceable. Lead- water, 
in this state, has likewise been employed with some success, by ar- 
resting the progress of the complaint. Every thing that tends to 
irritate, such as rubbing, picking, or handling the affected part, should 
be avoided. The clothing should be so regulated as not to press 
too hard on the tumour, nor to keep it disagreeably warm, nor leave 
it painfully cold. 

When the cancer becomes ulcerated, various have been the ap- 
plications, but those which give the least pain are the most eligible. 
The narrow-leafed dock-root has proved an effectual cure of this 
malady, in many instances. The manner of applying it, is by boil- 
ing the root till it is quite soft, then bathe the part affected, with the 
decoction, three times a-day, as hot as can be borne, using the root 
in form of poultice. 

Another remedy for this disease, is the solution of arsenic. It is 
to be taken inwardly, thrice a-day, in its usual doses, (see Dispensa- 
tory,) and to be applied externally in a diluted state. A drachm of 
the solution is first to be diluted with a quart of rain water, and 



COMMON ULCERS. 353 

made gradually stronger, till it be double of that strength. This 
mixture may be either applied on lint, or made into a poultice with 
the crumb of bread. 

The solution of kali on lint, has also been employed with some 
success in cancerous ulcers, beginning with it weak, and gradually 
increasing its strength. 

The charcoal powder (see Dispensatory,) is an excellent applica- 
tion to cancerous sores, particularly when they have an offensive 
smell. It may be daily applied in powder on lint, carefully observ- 
ing not to expose the ulcer to the air on changing the dressing. 
Carrots (see Materia Medica,) are also a good application to fetid 
ulcers. 

The beech-drop taken internally in the form of infusion or decoc- 
tion has been productive of great benefit in destroying the cancerous 
diathesis. It is upon good authority I am enabled to mention the 
application of a paste made of common table salt beat up with the 
yolk of an egg. 

The progress of this malignant disorder has been arrested by the 
preparations of chlorine. 

An English surgeon has met with considerable success with the 
application of a paste made of one part of the chloride of zinc and 
three of flour. This was well mixed and moistened with water and 
applied over the ulcerated parts. Half a grain of the chloride was 
taken in a wine glass of caraway water every morning after break- 
fast. A lotion was also used made of one drachm of the chloride of 
zinc to a pint of water. 

The chloride of lead has also been used with very great success 
by the same individual, in form of a wash, consisting of one drachm 
of chloride of lead to a pint of water. 

At the same time the chloride of potassium ten grains in caraway 
water was given three times a-day. The chloride of lead has been 
extensively used in many cases of disease of the breast and uterus, 
in the form of both lotion and ointment with much success. It ap- 
pears to act upon the nerves, paralyzing them and thus producing 
ease. 



COMMON ULCERS. 

No disease occurs more frequently among the poor and negroes, 
than ulcers of the legs ; for this obvious reason, they are more ex- 
posed to accidents, and when they meet with a wound or contusion 
in the leg, the injured part inflames, and becomes an ulcer for want 
of proper care. Women with obstructed menses are also subject to 
this disorder. 
45 



354 COMMON ULCERS. 

Ulcers receive various appellations, and require different modes of 
treatment, according to their appearances, or the causes and pecu- 
liarities of the constitution of the patient. Where the disease is 
local, topical remedies only are necessary ; but when it is connected 
with any disorder of the constitution, medicines that affect the whole 
system, are absolutely necessary. When ulcers appear to have had 
any effect, either in carrying off or preventing disorders to which the 
constitution may have been liable, a cure should not be attempted, 
until an issue be made in some more convenient part, which should 
be made to discharge nearly as much as the ulcer. (See Issues.) 

An ulcer not attended by any considerable degree of pain and 
inflammation, and which affords a discharge of mild matter, of 
whitish consistence, the granulation firm, red, and of healthy ap- 
pearance, is called the simple purulent ulcer, and is entirely a topical 
affection. This ulcer is the most simple that can occur, both in its 
symptoms and method of cure ; and it is to the state of such a sore 
that every other species must be reduced before a permanent cure 
can be effected. 

The causes of purulent ulcers are, all wounds that do not unite 
without the formation of matter, and every external accident that 
terminates in suppuration, with an opening as a consequence of it. 

In the cure of this species of ulcers, first remove any inflammation 
which may attend it, by emollient poultices, as bread and milk, 
renewed every three hours. As soon as the inflammation subsides, 
omit the poultices, lest the granulations be rendered lax and flabby, 
but keep the sore clean, and dress with some mild ointment, such as 
Turner's, or the simple cerate, (see Dispensatory,) spread veiy thin 
on soft lint, or apply dry lint, and upon that, a piece of linen spread 
with the ointment. The thorn apple ointment (see Materia Medi- 
cal is a most valuable application to heal sores. The frequency of 
dressing ulcers must depend on the quantity of matter discharged ; 
but in general, they should be dressed once in twelity-fonr hours in 
winter, and twice in summer, and the greatest care should be taken, 
in renewing the dressings, not to expose the sore for any time to the 
air. When the ulcer is filled up with sound flesh, the remaining 
part of the cure consists in the formation of a cicatrix. This is fre- 
quently the work of nature, but, in many cases, when every defi- 
ciency appears to be supplied, still a cure is tedious, the surface of 
the sores remaining raw, and discharging freely. In such cases, the 
sores should be washed twice a-day, with simple lime-water, or with 
some of the astringent washes. (See Dispensatory.) 

Ulcers of the irritable kind, which yield a thin ichorous discharge, 
sometimes bloody, and give a pain on being touched, are brought to 
a favourable state by warm fomentations, as decoctions of marsh-mal- 
lows, slippery elm, wormwood, camomile flowers, or hops, (see Ma- 
teria Medica,) and by poultices of the same ingredients, to which 
may be added bruised flax-seed or oatmeal. But as soon as the irri- 
tability of the ulcer is removed, these applications should be discon- 
tinued, and the common remedies for ulcers employed. 



COMMON ULCERS. 355 

However, there are cases of irritable ulcers being rendered more 
painful by the application of any thing warm, and when this hap- 
pens, such fomentations are not to be employed. There the sweet 
oil or saturine poultices applied cold, will be found most beneficial. 

Indolent ulcers, which are marked by a backwardness in forming 
granulations, and in those that are formed, a want of sufficient 
strength to bring about a complete cure, require stimulating appli- 
cations, as lime-water, solution of kali, blue vitriol, or any of the 
astringent washes. Lint dipped in either of these solutions, that 
may be found to agree best with the patient, should be applied twice 
in twenty-four hours to the sore, after being carefully cleansed with 
Castile soap and water. The strength of the solution should be 
gradually increased every two or three days ; for what at first gives 
considerable pain, will soon lose that effect. Tincture of myrrh, 
pure or diluted, according to the state of the ulcer, is, in many in- 
stances, a good application, and a decoction of walnut leaves, is 
exceedingly useful in disposing foul ulcers to heal. 

In some superficial ulcers, attended with a thickening of the skin, 
and when there is an unusual coldness of the limbs, without any 
tendency to mortification, warm salt water has been used with the 
greatest advantage. 

There is nothing of more importance, both in facilitating and 
ensuring a permanent cure of ulcers on the legs, than compression, 
which, however, should never be employed until the inflammation 
has subsided. As soon as this desirable event has taken place, and 
the usual dressings are applied, the affected part should be covered 
with several foldings of soft linen rags, and the whole secured upon 
the part with a calico or flannel bandage, three inches in breadth, 
and four or five yards in length ; or rather, as much as will support 
the limb from the foot to the knee. 

This bandage should be applied with as much firmness as can be 
borne by the patient, and as much evenness as possible, by passing 
it first round the leg at the ankle joint, then once or twice round the 
foot, and afterwards up the limb in a spiral manner, until it reaches 
the knee, observing that each turn of the bandage has its lower edge 
about an inch above the lower edge of the fold next below. If the 
compression should give pain and produce inflammation, the part 
that is affected should be moistened with cold water, poured from a 
tea-kettle or tea-pot, and repeated as often as the above symptoms 
may indicate the necessity. 

Should any disease prevail, its removal must first be effected. If 
the patient be weak, the diet should be nutritious, and tonic medi- 
cines, as bark, or the nitric acid, given in their usual doses. But if, 
on the contrary, of a plethoric habit, he should observe a spare and 
cooling regimen, and take a tea-spoonful of cream of tartar and (lour 
of sulphur thrice a-day. In obstinate cases, small doses of calomel, 
until the system become affected with it, or the use of pokeberry 
bounce, will assist the cure. 



356 wounds. 



WOUNDS. 



The cure of all wounds is effected two ways, either by adhesion 
or suppuration ; and previously to attempting either of these modes, 
the hemorrhage or farther effusion of blood should be restrained, and 
any extraneous substance removed. 

Hemorrhages are to be restrained by the application of dossils of 
lint, or by the tourniquet, or pressure with the hand, above the 
wounded part, until a ligature be applied. 

In dangerous hemoiThage, or bleeding in the extremities, we have 
known the curative operations wonderfully assisted by simply raising 
the limb as perpendicularly as possible. In the erect posture, the 
gravity of the blood so checked its velocity, as to enable the surgeon, 
with great care, to stop its effusion, which he had not been able to 
effect while the limb was pendant, and its vessel distended with blood. 

Simple as this suggestion may appear, it is a new discovery in the 
science of healing, for which we are indebted to Professor Physic, 
whose extraordinary skill in that noble art, has conciliated to him 
that very amiable title, " the American Hunter," and, for safety of 
all surgical operations, has placed Philadelphia on the same high 
level as Edinburgh itself. 

When ligatures are necessaiy, in consequence of large arteries 
being wounded, the following rules are to be observed in applying 
them : If you have no tourniquet, take a garter or a cord, make a 
small linen cushion, about four or five inches long, three broad, and 
and about two thick, or roll up a handkerchief hard, in a similar 
form, and lay it on the trunk of the artery, above the wounded part ; 
put the garter or cord over the handkerchief, round the limb ; tie a 
knot, leaving a proper space ; and then twist the ligature with a piece 
of stick, until the hemorrhage be completely restrained ; you are then 
to prepare a ligature, formed of two or three white waxed threads, 
proportioned to the size of the vessel ; after which, slacken the ban- 
dage, in order, by its hemorrhage, to discover exactly the situation 
of the artery, and with a tenaculum or a crooked needle, stick its 
point into the coat of the artery, and draw out the latter for the eighth 
of an inch, when a ligature, previously placed over the instrument 
in the manner of a ring, by one of the ends being put twice through 
the other, termed the surgeon's knot, is to be pulled over the point, 
of the needle by an assistant ; and when upon the vessel, its two 
ends should be drawn gently, until the sides of the latter be com- 
pressed. A second knot, if the artery be large, may be then made ; 
after which, the instrument is to be removed, and the ends of the 
thread or ligature cut off, at such a distance, that they may hang at 
least one or two inches without the edge of the wound. 

When a small artery is wounded, if it be divided, it retracts, and 



wounds. 357 

the hemorrhage presently ceases. If it be punctured, the wound 
should be enlarged, and then the artery may be tied, if proper pres- 
sure prove ineffectual. Sand, dust, and small pieces of glass, &c, 
are best removed by washing the parts in warm water, either by 
means of a sponge, or of a syringe. 

In the third place, as the principal object, proceed to the employ- 
ment of those means, which will probably heal the wound in the 
most easy and expeditious manner; for the longer this be neglected, 
the less is the part disposed to heal. — Whenever the nature of the 
injury will admit of it, the divided parts should be immediately 
brought into contact, the irritation excited by the wound itself, will 
then generally be productive of a certain degree of inflammation, 
which will accomplish a union in the course of a few days ; how- 
ever, in relaxed habits, with symptoms of debility, the application of 
some stimulants, as Turlington's balsam, spirit, or balsam of apple, 
will be required to produce that effect. The wound is then said to 
be healed by the first intention, and this mode of cure should always, 
when practicable, be attempted. The means of drawing, and pre- 
serving divided parts in contact, are bandages, adhesive plasters, and 
sutures. With respect to the two first, these should always be pre- 
ferred to the latter, in wounds that do not penetrate to any considera- 
ble depth. 

The mode of applying adhesive plasters is by straps ; one half of 
which is fastened on one side of the wound, and the other on the 
skin on the other side of the wound, drawing it tight, and holding it 
firmly, until the warmth of the part secures it ; but if the wound be 
deep, this contact of the sides must be made by sutures. 

In forming sutures, it should be observed, that one stitch, or suture, 
is sufficient for every inch of wound, and that the ligature or stitch 
should always be carried near the bottom of the wound, and the 
threads passed from within, outwards. Thus, a needle being put 
upon each end of the same thread, well waxed, and each of the 
needles inserted at the bottom of the sore, when pushed outwardly, 
about half an inch to an inch from the edge of the wound, accord- 
ing to its depth, will form one stitch, and the needle being with- 
drawn, the same thing must be repeated, according to the extent of 
the wound. When all the stitches are completed, the lips of the 
wound are to be pressed together, and supported in that position, 
until the ligatures are tied in the manner as already directed for 
making a surgeon's knot. 

It is of consequence to observe, that where the sutures or adhesive 
plasters have been neglected at first, they may be employed with 
advantage during any stage of the sore, as the parts will unite at any 
time very readily; and it will expedite the cure very much, to bring 
the edges of the ulcer into contact, whenever it can be done. When 
the parts are brought together, in the maimer directed, in order to 
prevent the access of air, it will be proper to cover (hem with lint, 
spread either with a thick mucilage of some mild gum, or some 



35S WOUNDS. 

bland ointment; as the simple saturine, or thorn apple ointment. 
In debilitated or relaxed habits, apply Turlington's balsam. (See 
Dispensatory.) 

The first dressing of wounds should never be removed, until the 
cure be completed, or until they appear covered with matter, unless 
the pain in the wound become severe, and be productive of much 
inflammation; and then the dressings should immediately be re- 
moved, and the parts gently rubbed with some olive oil, and a plas- 
ter of saturine cerate, spread on soft lint, applied. If this prove 
insufficient, and the inflammation be observed to rise still higher, a 
separation of the lips, the stitches tense, and the points where stitches 
pass, particularly inflamed, cut the ligatures, and take away every 
thing that is like stricture upon the wound. All hopes of procuring 
adhesion must now be abandoned, and the wound should be brought 
to a speedy and plentiful suppuration, by flax-seed, or milk and 
bread poultices, often renewed; and as soon as there is a full ap- 
pearance of pus with relief of the more violent symptoms of inflam- 
mation, the poultices should be laid aside, and the sore then treated 
as a simple ulcer. . 

When the sutures or plasters have been applied, and the symp- 
toms of pain and inflammation continue moderate, they may gene- 
rally be removed about the fifth or sixth day, as a union will by that 
time be produced. 

Gun-shot, # or lacerated and contused wounds, as marked by theii 
ragged and unequal edges, are the most dangerous of all others, 
from their disposition to gangrene. Hence, it is obvious, that in 
these wounds, the means to guard against mortification should be 
early employed. In the treatment of wounds of this description, 
three stages are to be observed in its progress, which may be termed 
the inflammatory, suppurant, and the incarnating. In the manage- 
ment of the first or inflammatory stage, especially if the patient com- 
plain of much pain, blood-letting should be had recourse to, and re- 
peated according to the violence of the inflammation and strength 
of the patient ; and, if possible to procure leeches, these should be 
applied near the edges of the sore. Emollients are then to be used, 
as pledgets of mild ointments on the wound, with poultices of bread 
and milk, or flax-seed laid above, and renewed every three or four 
hours, in order to promote a speedy suppuration, which are the best 
means of preventing gangrene. When the pus is freely formed, a 
separation of the most injured parts takes place, and as soon as they 

* Speaking of gun-shot wounds reminds me of a most awful and melan- 
choly event, which not long since took place in Charleston, S. C. — I mean 
the death of the great physician and historian, Dr. David Ramsay. 

This gentleman,, whose urbanity of manners, and extraordinary literary ac- 
quisitions, had rendered him the brightest ornament of science and society, 
was suddenly cut off amidst his usefulness to his family and country, by the 
pistol of a lunatic. The untimely fate of so truly amiable a man, and so dis- 
tinguished a physician and patriot, as Dr. Ramsay, will long be remembered 
with the deepest regret. 



wounds. 359 

have come away, the edges of the wound may be brought together 
by plasters or bandages, but no kind of suture should be employed ; 
and the sore will then come to be treated as a simple ulcer. 

In the second or suppurant stage, the chief point is to check the 
excess of suppuration, and dispose the wound to heal. This depends 
on a light nourishing diet, with wine, and the plentiful exhibition of 
bark and elixir vitriol. 

The third or incarnating stage is promoted, by placing the mem- 
ber in a proper position, to give a free discharge of matter, assisted 
by pressure at the same time, and by opening every collection which 
appears, by removing splinters, bones, or whatever causes irritation ; 
and by healing with astringent dressing of lint, dipped in the solu- 
tion of alkali, lime-water, or any of the astringent washes, (see Dis- 
pensatory^) when the discharge is excessive. 

In the progress of wounds, certain constitutional symptoms arise, 
that demand particular attention: these are pain, inflammation, and 
convulsive affections. The first of these usually goes off in a short 
time, by attending to the posture and ease of the wounded part, and 
moving any extraneous irritation ; but when it continues very vio- 
lent, and for a longer time than usual, it will be necessary, in the 
first place, to try the effects of laudanum, in doses of eight or ten 
drops every two or four hours ; and when the inflammation is vio- 
lent, to unload the vessels by topical bleedings ; which may be farther 
aided by fomentations and emollient poultices. If these be insuffi- 
cient, and the pain still continue acute, it probably depends on a 
partial separation of nerves ; to relieve which, a complete division of 
them should be made. The latter complaints are spasmodic, which 
vary in degree from the slightest convulsive twitching, to the highest 
state of the spasm in the attack of the lock jaw. They are fre- 
quently the effects of trifling injuries : a small scratch, for instance, 
which does not penetrate to a greater depth than the skin, will some- 
times induce them; and, when they happen as the consequence of 
large wounds, they do not make their appearance until the sore 
seems nearly healed. 

Upon the first symptoms of these affections, the patient should be 
immersed in a bath of warm water, soap-suds, or a lye made with 
wood ashes, as long as he can bear it, and opium should be exhibited 
in pretty large doses, every two or three hours, as the symptoms may 
indicate. When this fails, the malady is to be treated by remedies 
prescribed for tetany. 

The constitutional treatment of wounds requires, during the in- 
flammatory stage, the strictest attention to the cooling regimen, a low 
spare diet, the occasional use of laxatives, and the wounded part 
kept in such a situation as affords most relief. When suppuration is 
formed, a fuller diet will then be necessary; and if the discharge of 
matter be excessive, bark and elixir vitriol must be employed. 



360 MORTIFICATION. 



MORTIFICATION. 

The word mortification, in its present acceptation or meaning, is 
generally supposed to have place where the circulation is no longer 
performed through the diseased part, which generally turns black, 
and becomes putrid, producing a separation of the diseased surface 
from the sound flesh, like an eschar, in consequence of a caustic 
having been applied. In the incipient stage of this disease, which 
is termed gangrene, there is generally a very high degree of inflam- 
mation, and a swelling of the parts affected, with some vesications, 
like those from scalds, but of different colours, according to the ex- 
travasated fluid, with which they are replete ; sometimes pellucid or 
yellow, at other times black or brownish. 

While things are in this state, attempts should be made to prevent 
a sudden change to a mollification : but, in order to effect this, it 
must be observed, that a tendency to mortify may be owing to very 
opposite causes. It must, therefore, be extremely obvious to eveiy 
man of consideration, that there cannot be any thing properly a spe- 
cific for a disease, where a plethora or fulness is the cause in one 
subject, and inattention in another. 

We know very well that all inflammations may terminate in mor- 
tifications. It is also of importance to know, that where there is a 
languid circulation, as in old age, or in cases of excessive debility, 
from protracted fevers, the extremities not only threaten soon to be- 
come gangrenous, but the progress to mortification is often veiy rapid 
under such circumstances ; for not only the vital heat is deficient, but 
the vessels themselves are frequently diseased ; and, though duly 
distended with blood, are incapable of reacting on the contained 
fluid, which, consequently, in time, must stagnate in the small 
vessels. 

Hence, it is obvious, that a mortification may proceed from a cir- 
culation that is too rapid, or too languid; and, consequently, the 
treatment must vary according to circumstances, and the cause of 
disease. 

In the first case, general blood-letting, diluent drinks, with nitre 
dissolved in them, and the cooling regimen in every respect, are in- 
dispensable for its cure. And in the second, a liberal use of cordials 
and invigorating medicines, as wine and bark, to raise and maintain 
the vital heat, and to check the progress of putrefaction, can alone 
be depended upon. 

When the mortification proceeds from too languid a circulation, 
or when there is much pain, opium or laudanum is one of the great- 
est cordials, and should be taken freely every three or four hours, 
but not in such doses as to produce a narcotic effect. 

The best external application to arrest the course of gangrene or 



SPRAINS AND BRUISES. 361 

mortification, is to apply a blister over the gangrenous part, suffi- 
ciently large to cover one or two inches of the sound flesh, and after- 
wards to dress the part with cataplasms, made of bark, charcoal 
powder, and yeast, to be renewed every three or four hours, or as 
often as they acquire a putrid smell. 

When the mortified parts begin to separate, remove no more at 
each dressing than comes away without pain or loss of blood ; and 
as soon as the gangrene stops, and granulations of good flesh appear 
it is to be treated as a simple ulcer. 



SPRAINS AND BRUISES. 

In the treatment of sprains and bruises, the chief point is to give 
an instantaneous vigour to the solids, so as to prevent the increase 
of effusion. Hence, the part should be instantly plunged into cold 
water. After this, cloths wetted with vinegar or lead-water, to 
which, laudanum may be added, should be applied, and renewed as 
fast as they grow warm, until the pain and inflammation have 
somewhat subsided. The sprained part may then be dressed two 
or three times a-day, with a bandage of brown paper, dipped in warm 
vinegar and spirits, or embrocated with opodeldoc or volatile lini- 
ment, (see Dispensatory,) always observing to preserve the part in 
the easiest and most relaxed posture. 

In addition to this local treatment, if the patient be of a plethoric 
habit, or the injury very severe, blood-letting, cooling cathartics, and 
a light diet, are particularly enjoined. When bruises have been ne- 
glected at the onset, or become painful, warm fomentations of bitter 
herbs are extremely useful ; and their good effects will be considera- 
bly aided by applying the ingredients themselves as a poultice to the 
part, as warm as can be borne, and sprinkled with a little finely 
powdered camphor. 

After serious sprains, the patient often complains of weakness and 
uneasiness in the injured parts. In such cases, a stream of cold 
water poured on the part at a considerable height, from the spout of 
a tea-kettle or pitcher, two or three times a-day, completes the cure, 
especially if a flesh brush or flannel be vigorously used immediately 
before and after the application. Some assistance will likewise be 
obtained by the use of a bandage or roller, to confine the swelling 
when that symptom occurs. 

46 



362 DISLOCATIONS. 



DISLO CATIONS. 

Dislocation is the removal, by force, of an articulated bone 
from its natural situation, which is easily known by a degree of 
protuberance on one side, equalled by a corresponding hollow on 
the other; by comparing the joint of one member injured with its 
fellow ; by an inability to move the injured limb ; and by pain and 
tension in the part affected. In whatever part a dislocation happens, 
it is of great importance to have it reduced as soon as possible, 
because, by delay, the operation becomes extremely difficult, and is 
very frequently rendered impracticable, after the inflammation and 
swelling have come on. 

Therefore, whenever this accident happens in the country, if medi- 
cal assistance cannot immediately be obtained, the most intelligent 
person present should reduce the bone. 

In the replacing of dislocated limbs, the principal object to be 
attended to, is the mode in which the extension is made ; for the 
success of the operation depends more on this, than the force with 
which it may be applied. Therefore, gradually extending from one 
side to the other, and gently moving it upwards and downwards, is 
more likely to succeed, than strong extension in a right line : the 
force should be begun very gradually, and increase slowly at each 
trial, in case it resists the first. In case of a luxation being obstinate 
to reduce, bleeding, so as to cause faintness, may often be used ad- 
vantageously, and whilst the patient is in a weak state, there is a 
greater probability of success, from extension well directed ; the 
operator, at the same time, endeavouring, with his hands to replace 
the dislocated end of the bone. 

After the bone is replaced, compresses made by two or three folds 
of old linen, wetted with vinegar or lead- water, should be constantly 
applied to the part, in order to obviate inflammation ; and the limb 
should be retained in its natural situation, by bandages, which should 
neither be applied over-tight, nor over-lose ; as in one case, the}' 
would compress too much, and in the other, they would be of no 
use to the parts. 

Where inflammation has taken place before the reduction is ac- 
complished, it cannot be performed until that be overcome. For 
this purpose, we must adopt the antiphlogistic plan, such as bleeding, 
keeping the bowels in a laxative state, by the occasional use of the 
cathartic mixture, and using warm drinks, together with the cam- 
phorated powders, and the antimonial solution, (see Dispensatory,) 
in their usual doses, in order to promote perspiration. 



DISLOCATIONS. 363 



DISLOCATION OF THE JAW. 

The lower jaw may be luxated by yawning, blows, falls, chewing 
hard substances, or the like. This accident may be known to have 
taken place from the patient's being unable to shut his mouth, or eat 
any thing. The chin, likewise, either hangs down, or is wrested to 
one side; and the patient is neither able to speak distinctly, nor to 
swallow without considerable difficulty. 

The common method of reducing a dislocated jaw is to place the 
patient upon a low stool, in such a manner, that an assistant may 
hold the head firmly, by pressing it against his breast. The operator 
is then to push his two thumbs, (protected with linen cloths, that 
they may not be bitten when the jaw slips into its place,) as far back 
into the patient's mouth as he can, and then, with his fingers applied 
to the outside of the angle of the jaw<| endeavour to bring it forward, 
till it move a little from its situation. He should then press it forci- 
bly downwards, and backwards; by which means the elapsed heads 
of the jaw will immediately slip into their place. 

DISLOCATION OF THE SHOULDER. 

The humerus or upper bone of the arm is the most subject to 
dislocation of any in the body, and may be luxated in various 
directions. The accident, however, happens most frequently down- 
wards, and very seldom directly upwards. This dislocation may 
be discovered by the patient's inability to raise his arm, as well 
as by violent pain in attempting it, and by a depression of cavity 
on the top of the shoulder. When the dislocation is downward 
or forward, the arm is lengthened, and a ball or lump is perceived 
under the armpit; but when it is backward, there appears a protu- 
berance behind the shoulder, and the arm is thrown forward toAvards 
the breast. 

The usual method of reducing a dislocation of shoulder is to set 
the patient upon a low stool, and to cause an assistant to hold his 
body firmly, while another lays hold of his arm a little above the 
elbow, and gradually extends it. The operator then puts a napkin 
under the patient's arm, and causes it to be tied behind his own 
neck. By this, while a sufficient extension is made, he lifts up the 
head of the bone, and with his hands directs it into its proper place. 
In young and delicate persons, an operator may generally reduce 
this dislocation by extending the arm with one hand and thrusting 
in the head of the bone with the other. In making the extension, 
the elbow ought always to be a little bent. 

If much difficulty occur in the operation, blood-letting, sometimes 
so far as to produce fainting, becomes necessary. This remedy 
seldom fails to facilitate the reduction. 



364 DISLOCATIONS. 



DISLOCATION OF THE ELBOW. 

The bones of the fore-arm may be dislocated in any direction, 
but most commonly upwards and backwards. In this luxation, a 
protuberance may be observed on that side of the arm towards 
which the bone is pushed ; from which circumstance, joined to the 
patient's inability to bend his arm, a luxation at the elbow may 
be known. 

For reducing a dislocation at the elbow, two assistants are, for the 
most part, necessary : one of them must lay hold of the arm above, 
and the other below the joint, and make a pretty strong extension, 
while the operator returns the bones into their proper place. The 
arm must afterwards be bent, and suspended for some time with a 
sling about the neck. 

Dislocations of the wrist and*fmgers are to be reduced in the same 
manner as those of the elbow ; namely, by making an extension in 
different directions and thrusting the head of the bone into its place. 

DISLOCATION OF THE THIGH. 

When the thigh-bone is dislocated forward and downward, the 
knee and foot are turned out, and the limb is longer than the other ; 
but when it is displaced backward, it is usually pushed upward at 
the same time, by which means the limb is shortened, and the foot 
is turned inward. 

When the thigh-bone is displaced forward and downward, the 
patient, in order to its reduction, must be laid upon his back, and 
made fast by bandages, or held by assistants, while by others an ex- 
tension is made by means of slings, fixed about the bottom of the 
thigh, a little above the knee while the extension is made, the ope- 
rator must push the head of the bone outward until it gets into the 
socket. If the dislocation be outward, the patient must be laid 
on his face, and during the extension the head of the bone must be 
pushed inward. 

Dislocations of the knees, ankles, and toes, are reduced much in 
the same manner as those of the upper extremities; namely, by 
making an extension in opposite directions, while the operator re- 
places the bones. In many cases, however, the extension alone is 
sufficient, and the bone will slip into its place merely by pulling the 
limb with sufficient force. It is not hereby meant that force alone 
is sufficient for the reduction of dislocations. Skill and dexterity 
will often succeed better than force ; and One man who possesses 
them has been able to perform what the united force of many was 
found inadequate to accomplish. 



INJURIES OF THE HEAD, AND FRACTURES. 365 

INJURIES OF THE HEAD 

AND FRACTURES OF THE LIMBS. 

If, in consequence of a bad fall, or blow, a considerable injury 
appear to have been received, the sufferer being unable, in conse- 
quence of the loss of his senses, to point out the injured part, some 
consideration is necessary, before any attempts are made even to 
raise him from the ground. Because, should a fracture of one of 
the bones have happened, and not suspected by his assistants, their 
exertions to raise him, and to place him on his feet, might force the 
ends of the fractured bone through the soft part, and convert a sim- 
ple fracture into a very dangerous compound one. The limbs, 
therefore, should be carefully examined ; but even if they seem to 
have sustained no material injury, yet should the patient not be 
precipitately raised, until something be provided, on which he may 
be placed; as, thereby, unnecessary and perhaps injurious exertions 
are avoided. 

As it will be fair to conclude, from the deprivation of the senses, 
that the brain may have received some injury, great care should be 
taken to convey the patient to his apartment, with as little injury as 
possible : and, whilst lying in bed, the head should be somewhat 
raised. If the patient be of a plethoric habit, a moderate bleeding 
will be required as soon as possible after the accident ; after which, 
the bowels should be evacuated either by purgative medicines or 
clysters. One or two stools being procured, and if possible the warm 
bath used, the anodyne sudorific drops, (see Dispensatory^) should 
next be exhibited to produce perspiration, and to excite absorption 
of the extravasated blood ; and this mixture should be continued, in 
doses of ten or twelve drops, every four or six hours, until the patient 
is out of danger, observing to keep the bowels open. 

During convalescence, the bark, Columbo, or steel, with wine 
may be employed. If there be a laceration of the scalp, every at- 
tempt should be made to induce suppuration of the part, by the 
application of warm fomentations or poultices, and this taking place, 
a relief of all the symptoms will occur, when it is to be treated as a 
simple wound. 

But should it be discovered, that a leg or thigh is broken, the 
patient is not to be stirred until a proper vehicle, as a door, or two 
or three boards well secured together, is procured, on which he can 
be placed. To place him on this, two persons may raise him by 
means of a sheet slid under his hips, whilst one raises him by the 
shoulders, one person raising the sound leg, and one carefully con- 
ducting the fractured limb, which should be placed on a pillow, with 
the knee a little bent. The best mode of conveyance, is undoubl 
edly by two or four men, and a carriage should never be employed. 



366 

when this mode can be adopted. As the patient will be under the 
necessity of lying some time without getting up, much subsequent 
pain and exertion will be prevented, by preparing the bed in the 
following manner : — 

In place of the laced canvas, bottom boards are to be laid across 
the bed frame, which makes the bed hard, and keeps it perfectly 
level and smooth during the cure. In place of a feather bed, a 
mattress only is to be laid above those boards ; over this another, cut 
into four parts, with a piece of a sheet sewed round each portion, is 
to be placed, that they may be shifted under the patient from time 
to time. On the bed, thus prepared, a pillow, like a mattress, flat 
and firm, is to be laid for receiving the limb. 

In setting a broken bone, very little extension is required, nor 
should tight and firm bandages be used, which give considerable 
pain to the patient without the least benefit. In a simple fracture 
of the thigh or leg, with patients not unruly, very little more is 
necessary than to restore the foot to a right direction with regard to 
the leg, and then stretch out the limb on a well made pillow, ob- 
serving to extend, straighten, and lay it anew, when it is disordered 
or shortened, without fear of hurting the callus. And when you 
have placed the limb between two splints, or troughs, made of un- 
tanned leather or pasteboard, which have been previously soaked 
and softened, the whole braced down with ribands or tapes, to pre- 
serve it steady, you have done every thing. 

Having prepared two long troughs, or pieces of untanned leather 
or pasteboard bent in a hollow form, lined, or rather cushioned with 
two or three folds of flannel, with tapes or ribands, four or five in 
number, attached to the outside of one of the splints, by which both 
splints may, after all is over, be gently tied together with bow knots, 
to be slackened or tightened, according to the swelling of the limb ; 
you are then to place these by the side of the fractured leg, and 
direct one of the assistants to apply his hands broad around the upper 
part of the limb, and grasp it gently and steadily ; take the foot and 
ankle in the same manner in your own hand ; slip your left hand 
under the broken part of the limb, slide it gently along, and then lay 
it upon the splints, to which the ribands are attached. 

If the bone cannot be reduced by this extension, endeavour to 
force it in with your thumbs. Begin then to la)?- the limb smooth ; 
let your assistant again grasp it, by spreading his hands upon the 
thigh, or below the knee, with the design of extending, along with 
you, not by lifting the leg from the pillow, but rather by keeping it, 
down, and steadying it by pressure, while you, with both hands, lift 
the foot and ankle, grasp them gently, but firmly ; raise them a little 
from the pillow, and draw gently, steadily, and smoothly. When 
you have thus extended and smoothed the broken leg, in a manner 
which you almost suppose agreeable, rather than painful, to the 
patient, press it down gently, and steadily upon the lower splint ; the 
upper is then to be laid above it ; and by grasping the soft and 



INJURIES OF THE HEAD, AND FRACTURES. 367 

moistened splints, you must model them a little to the shape of the 
limbs. When the whole has taken a form, tie several tapes, one 
after another ; and after having tied them in a general way, go over 
them again, one by one, and tie them a little ck>ser, so as to keep 
the limb agreeably firm. 

The process is either slower or more imperfect in children and old 
people : their bones, therefore, are more apt to be broken again ; 
hence, with them, the splints should be kept longer applied. On 
particular occasions, also, particular precautions must be taken. 
Thus, with delirious patients, and those who are liable to sudden 
motion, as when at sea, the limb, after being set, must be laid be- 
tween two pillows, and the pillows fastened to the bed. It is, also, 
sometimes necessary to make the splints more secure, and this may 
be done by soaking a roller or bandage in whites of eggs, mixed 
with a little flour ; or by strewing a little powdered rosin on the 
bandage, and afterwards soaking it with spirits of wine ; or, finally, 
by soaking the bandage with fine glue, which makes a firm case, 
and is far from being offensive. 

Lastly, though splints and bandages, in general, are unnecessary 
during the cure ; yet, when a patient rises from bed, rests the weight 
of his body on a fractured bone, and begins to be exposed to acci- 
dents, the splints laid along the limb should be made firm by a ban- 
dage or roller as above described, to prevent those accidents which 
may be incurred by precipitation and rashness. 

In fractures of the arm, the parts hang naturally in the best pos- 
ture, and require but two splints of thin pasteboard, rolled gently 
with a linen roller: and, in fractures of the forearm, the limb pre- 
serves its natural length or form ; it requires merely to be laid upon 
a long splint of pasteboard, with a small splint laid above, the two 
splints being secured with light ribands or tapes, and the arm, from 
the elbow to the fingers' ends, supported by a sling or handkerchief 
round the neck, raising the palm of the hand to the breast, with the 
fingers moderately bent. 

When the arm is fractured between the elbow and shoulder, the 
forearm may be placed in the same position, as already described ; 
but the sling, instead of supporting the whole length of the arm, 
should only support the hand, which should be raised higher than 
in the former case, the elbow being allowed to sink; its motion, 
however, being prevented, by a handkerchief passed moderately tight 
round the trunk, including the fractured arm. 

When the small bones happen to be fractured, they must, be re- 
placed and retained in their situation, by splints and bandages fitted 
to the part. In using splints of pasteboard or untanned leather, it 
is always necessary they should be applied, in the first instance, wet, 
so as to assume the form of the fractured part. After the first fort- 
night, the dressings should be occasionally removed, to allow some 
motion of the joints ; and then replaced, and daily removed for the 
same purpose. 



368 FRACTURES OF THE RIBS. 

When there is an external wound, communicating with the cavity 
of the fracture, it is termed a compound fracture. This sometimes 
occurs by the protrusion of the bone ; at other times by the same 
force which caused the fracture. In such cases, the bone is to be 
reduced by carefully attending to the posture of the limb, and by 
dilating the wound, when the bone becomes girded in it. The 
wound is then to be dressed with dry lint, in order to allow the blood 
to coagulate, which will form a kind of scab, and every effort should 
be made to unite the wound by the first intention, thereby convert- 
ing the accident to the state of a simple fracture. 

Almost all fractures are attended with contusion, and, conse 
quently, swelling ; the abating of which is the first step that should 
be taken towards the cure, and is to be effected by bleeding, if the 
patient be of a plethoric habit, by mild purges, a cooling regimen, 
and by the exhibition of the anodyne sudorific drops, as already 
described ; the application to the parts affected should be vinegar or 
lead-water, with crumbs of bread, or poultices made of stale beer, or 
vinegar and oatmeal, with a little oil to prevent their growing dry 
or stiff. 

The swelling of the limb being subsided, and the callus formed, 
cold water may be poured through the spout of a tea-kettle over the 
fractured limb, every morning, to restore the tone of the injured parts. 



FRACTURES OF THE RIBS. 

The ribs are broken, for the most part, near to the middle. 

The accident usually proceeds from blows or falls, and is known 
by an acute pain in breathing, and a crepitus or grating being per- 
ceived, on pressing the rib in different places. By carefully passing 
the hand over the rib, the inequality produced by the fracture may 
be sometimes distinctly felt. Coughing produces a crepitation, which 
is frequently perceptible to the patient himself as well as to the by- 
standers. 

The only treatment necessary, in simple fractures of the ribs, 
whether one or several be broken, is to keep the part, during the re- 
union, as much as possible in a state of rest. This is done by coun- 
teracting, to a considerable extent, their motion in respiration. To 
effect this, a bandage, six inches wide, is to be passed repeatedly 
round the chest, as tightly as the patient can suffer it to be drawn. 
Its slipping down may be prevented by means of a shoulder strap. 

Or, instead of a roller, a jacket, of strong linen, capable of being 
drawn very tight, by means of tapes, may be used. Until the re- 
union be completed, the patient should be kept as quiet as possible. 



BLOOD-LETTING. 369 

If the lungs be wounded by a splinter of the rib, blood will be 
spit up, and high fever and inflammation will be likely to ensue. In 
this case, blood must be drawn copiously from the arm ; and the 
patient should be treated, in all respects, as if he were labouring 
under pleurisy. 



BLOOD-LETTING. 

The art of opening a vein, and the necessary cautions respecting 
the operation, should be learned by every one ; since cases of emer- 
gency may happen, when the necessity of its being performed is evi- 
dent, and where life may be lost before medical assistance can be 
obtained. Another qualification necessary to be possessed, is that 
of being able to stop the flow of blood from a vein thus opened. 

To bleed, you are to apply a riband or ligature with a degree of 
tightness, an inch or two above the elbow joint; and as soon as a 
vein is conspicuous, place the thumb of your left hand about an 
inch below the place of your puncture, and then with your right 
hand, holding the lancet firmly betwixt your thumb and fore finger, 
make an incision obliquely into the vein, without changing its direc- 
tion, or raising the handle, lest the point, being lowered in propor- 
tion, should cut the under part of the vein, or perhaps even wound 
an artery.* 

When the quantity of blood you wish is drawn, unite the ligature, 
and close the orifice. To accomplish this, let the thumb be placed 
on the orifice, so as to bring its sides together, and to press it with a 
moderate force. The flow of blood will now be stopped, and the 
operator with the hand, must apply a compress, made by twice 
doubling a piece of linen, about two inches square, between the ori- 
fice and his thumb ; over this, place another compress, three or four 
inches square, of a thickness sufficient to fill up the hollow of the 
bend of the arm, confining the whole with a riband or tape, passing 
over the compress, and above and below the elbow, in the form of a 
figure eight, finishing with a knot over the compress. 

If the bleeding continue obstinate, the sleeve of the gown or coat 
above the orifice, ought to be ripped or loosened ; and if this do not 

* To discriminate between an artery and vein, is a matter of the utmost im- 
portance. This is readily done if proper attention be paid. 

The chief mark of distinction is, that the artery has a pulsation, which the 
vein has not. 

But frequently it happens, that an artery lies so immediately under a vein, 
that its pulsation may be felt through the vein. In such cases, it will be pru- 
dent not to open the vein, unless the operator is skilful ; for it must be attended 
with danger. 

4T 



370 BLOOD-LETTING. 

succeed, the lips of the incision should be brought nicely together, 
and while they are compressed firmly by the thumb of the operator, 
the coldest water should be poured on the arm, or orifice washed 
with sharp vinegar. The placing of a piece of adhesive plaster over 
the orifice in the vein generally succeeds in checking the flow of 
blood. 

To bleed in the foot, a ligature must be applied above the ankle 
joint, and after opening the most conspicuous vein, if the flow of 
blood be not copious, it may be increased by immersion of the part 
in warm water. On removing the ligature, the blood will readily 
cease to discharge, and a piece of court-plaster is the best bandage. 

Topical blood-letting is executed by the application of leeches, as 
near as possible to the part affected, or by a scarificator, or an instru- 
ment with a number of lancets acted upon by a spring. 

When leeches are employed they must be previously prepared by 
drying them, or allowing them to creep over a dry cloth; and the 
part to attract them should be moistened with cream, sugar, or blood, 
and they confined on it by applying a wine-glass over them. 

When the scarificator is used, as soon as a wound is made, a cup 
exhausted of its atmospheric air, by burning over it, for a few se- 
conds, a bit of a soft paper dipped in the spirit of wine, and on the 
flame of which, being nearly exhausted, must instantly be applied 
over the scarified part ; when full, it is easily removed by raising one 
side of it to admit the air. When you have taken away, in this 
manner, a sufficient quantity of blood, the wounds are to be covered 
with some cream or mild ointment. 

In the operation of blood-letting, certain morbid consequences at 
times arise, which demand a special treatment. 

The most common of these, is a swelling of the part, termed ec- 
chymosis ; and when it occurs, shifting the position of the arm, so as 
to induce a free discharge, will lessen the tumour, if not entirely re- 
move it. Should this fail, compresses, dipped in the solution of sal- 
ammoniac or brandy, are to be applied. These also failing, and 
the swelling still continuing, without any diminution, the tumour 
must be opened, and after removing the coagulated blood, the sore 
should be treated as a common wound. The result, however, very 
rarely occurs. 

Another consequence, which sometimes follows blood-letting, is 
an acute pain immediately felt on the introduction of the lancet, and 
communicated from the part to the extremity of the member. The 
treatment of this complaint consists in the early use of cloths, wrung 
out of lead-water, applied to the part, and adopting, in every respect, 
the antiphlogistic plan, as blood-letting, cooling cathartics, and a low 
diet, to obviate inflammation. 

This treatment not succeeding, laudanum must be given in large 
doses, which, also failing, a free division of the nerve or tendon, 
which was pricked with the lancet, is the only remedy left. 

The last accident required to be noticed, is the wounding of an 



BLOOD-LETTING. 371 

artery, which is known immediately after the operation, by strong 
compression of the vein, above and below the orifice, by the tremu- 
lous motion in which the blood flows, and by not being able to stop 
the discharge as usual. The cure of this affection may be attempted 
in the early stage by compressing, and observing the antiphlogistic 
regimen. On their failing, the tumour must be extirpated, and then 
the ends of the vessels secured by means of a ligature, until a re- 
union of the parts be effected, when the circulation is made to pur- 
sue a different channel. 



ISSUES. 

These are a kind of artificial ulcers, formed in different parts of 
the body, for the purpose of procuring a discharge of purulent matter, 
which is frequently of advantage in various disorders. Practitioners 
were formerly of opinion that issues served as drains to carry off 
noxious humours from the blood ; and, therefore, they placed them 
as near the affected part as possible. But as it is known that they 
prove useful, partly by the quantity of matter they produce, and 
partly by sympathy, they are generally placed where they will occa- 
sion the least inconvenience. The most proper parts for them are, 
the nape of the neck ; the middle, outer, and fore-parts of the shoul- 
der ; the hollow above the inner side of the knee ; or either side of 
the backbone : or betwixt two of the ribs ; or wherever there is a 
sufficiency of cellular substance for the protection of the parts be- 
neath. They ought never to be placed over the belly of a muscle ; 
nor over a tendon or thinly covered bone; nor near any large blood- 
vessel. The issues commonly used, are the blister-issue, the pea- 
issue, and the seton or cord. 

When a blister-issue is to be used, after the blister is removed, a 
discharge of matter may be kept up by dressing the parts daily with 
an ointment mixed with a little of the powder of cantharides, or 
Spanish flies. If the discharge be too little, more of the powder 
may be used; if too great, or if the part be much inflamed, the issue- 
ointment may be laid aside, and the part dressed with basilicon, or 
with common cerate, till the discharge be diminished, and the in- 
flammation abated. 

It is sometimes most proper to use the issue-ointment, and a mild 
one alternately. 

A pea-issue is formed either by making an incision with a lancet, 
or by caustic, large enough to admit one or more peas; though, 
sometimes, instead of peas, kidney-beans, a gentian-root, or orange- 
peel, are used. When the opening is made by an incision, the skin 



372 



MALIGNANT FEVER. 



should be pinched up and cut through, of a size sufficient to receive 
the substance to be put into it. But when it is to be done by caus- 
tic, (the common caustic,) or lapis infernal is of the shops answers 
best. It ought to be reduced to a paste with a little water or soft 
soap, to prevent it from spreading; and an adhesive plaster, with a 
small hole cut in the centre of it, should be previously placed, and 
the caustic paste spread upon the hole. Over the hole, an adhesive 
plaster should be placed to prevent any caustic from escaping, In 
ten or twelve hours the whole may be removed, and in three or four 
days the eschar will separate, when the opening may be filled with 
peas, or any of the other substances above mentioned. 

The seton is used when a large quantity of matter is wanted, and 
especially from deep-seated parts. It is frequently used in the back 
of the neck, for diseases of the head or eyes, or betwixt two of the 
ribs, in affections of the breast. 

When the cord, which ought to be made of threads of cotton or 
silk, is to be introduced, the parts at which it is to enter and pass 
out, should be previously marked with ink, and a small part of the 
cord being besmeared with some mild ointment, and passed through 
the eye of the seton-needle, the part is to be supported by an assist- 
ant, and the needle passed fairly through, leaving a few inches of 
the cord hanging out. The needle is then to be removed, and the 
part dressed. By this method, matter is produced in quantity pro- 
portioned to the degree of irritation applied; and this can be in- 
creased or diminished, by covering the cord daily before it is drawn, 
with an irritating or mild ointment. 






MALIGNANT FEVER.* 

In the year 1823, while the Epidemic Malignant Fever, some- 
times denominated the Cold Plague, was raging in the western 
and southern country, and when physicians were unsuccessful in its 
treatment, and divided about its nature and origin, the author re- 
ceived the following letterf from sundry respectable gentlemen, 

* This article, the author wished to place under the head of Fevers : but as 
it could not be conveniently prepared till the former portion of the volume was 
in type, and as the author has not aimed at a strict nosological arrangement, 
he thought it as well to introduce it at the end of diseases generally. 

Feliciana Parish, Louisiana, 
t Dr. James Ewell, September 24th, 1823. 

Dear Sir : — We have perused your Medical Companion, with pleasurable 
and profitable attention, and though professedly ignorant of the science of 
medicine, we deem that work a valuable addition to the libraries, and emi- 
nently deserving the grateful acknowledgments of your fellow-citizens, in 



MALIGNANT FEVER. 373 

citizens of Louisiana, asking information from him, as to the man- 
agement of a disease, which had proved so fatal in their neighbour- 
hood. The author, having no personal knowledge of the disorder, 
being far removed from the scene of its devastation, and having no 
sources for information, on which he could rely, was constrained to 
decline giving the advice requested. He has since met with the 
elaborate and satisfactory essays on the subject, written by Samuel 

consequence of its peculiar excellence and utility. That portion of it dedicated 
to Materia Medica, the Dispensatory, and a table of Medicine, entitles the 
author to the gratitude and respect of many families. From observation, we 
have found that those physicians are the most successful in their practice who 
have followed the directions which you have offered to the public. 

Entertaining an exalted opinion of your professional talents, we have con- 
curred in addressing this epistle to you, in the confident expectation, that your 
popular benevolence will prompt you to favour us with your valued advice on 
a disease, generally acknowledged mortiferous in this section of the union, 
which of all others has most severely suffered from annual epidemic distem- 
pers, mostly of a febrile description. 

The Cold Plague is the ordinary denomination of the formidable malady to 
which we allude, and for which no adequate remedy has, as yet, been dis- 
covered. 

To afford you some idea of its prevalence and malignity, we state the fact, 
that, in the space of ten days, our neighbour, Mr. Waddle, lost six of his 
household who were attacked by this disease ; that he himself is now its vic- 
tim, and is hurrying to the threshold of eternity; while his sister is, at the 
same time, confined to her bed, with all the symptoms of the same complaint; 
and this, sir, is but one instance of many thousands of the fatality of that dis- 
ease, which annually desolates Louisiana and the bordering state of Mississippi. 

That distance precludes you from personal contemplation of the symptoms 
of the cold plague, is seriously lamented by us, as it subjects you to disadvan- 
tage in prescribing, and us to less certain benefit from your medical knowledge. 
We will, however, attempt to describe it. One of the undersigned was seized 
with the cold plague, about the conclusion of August, 1821. 

Symptoms. — Pain in the stomach extremely violent; a vibrating coldness; 
a fever, during which a profuse perspiration took place, of twenty-four hours' 
continuance. Will it be credited, that while it was obvious to the physicians, 
that the patient was in a high fever, the latter felt a death-like coldness, in all 
parts of his body, except the region of the heart ! He was continually thirsty ; 
and, for three days and nights, complained of extreme pain in the stomach. 

We earnestly request you, sir, to give your opinion relative to the best 
method of treating this enemy of Louisiana. 

Address to Mr. William George Dixon, St. Francisville, Feliciana Parish, 
Louisiana. 
(Signed,) 

Angus Umphraville,1 A. W. Draughan, 



Benj. O. Williams, I r , Francis Brian, 

Robert Dyer, f* 1 ^ *' Eli Rentz, 

David Pipes, Sen. J Joseph Drawdy, 

Jesse Knighten, Merchant. H. R. Harrell, 

N. M. K. Reid, U. S. Surveyor. Joseph Vick, 

Wm. G. Dixon, "| Micajah Courtney, 

Wm. Campbell, I Robt. Neyland, 

John Rowley, V Planters. M. Dikson, 

Stephen Shelton, 
B. Chance, 



fe 



374 MALIGNANT FEVER. 

A. Cartwright, M. D. of Natchez, Mississippi, and published in the 
Medical Recorder, Vol. IX., year 1826. From these essays he has 
made copious extracts, which he presents to his very polite corres- 
pondents of Feliciana, and to the public, in general, as the best 
treatise on the cause, symptoms, and cure of malignant fevers, that 
has ever been published, and indeed the best which could be gath- 
ered from the whole stock of information on the subject, now pos- 
sessed by the profession. The thanks of the medical profession, and 
of the public, are due to Dr. Cartwright for his zeal and industry in 
investigating this subject, and for the ability with which he has 
communicated the results of his labours. 

Symptoms. — The disease was marked by three distinct stages, 
each of which had its peculiar symptoms. As it might, in its first 
and second stages, have been mistaken for some other malady, I will 
only describe the last stage, which presented features altogether pe- 
culiar, and could be confounded with no other disease whatever. 
In the last stage there was apparently no fever, and little or no pain. 
The patient often regained his strength so far as to be able, in the 
most of cases, to walk about his room. His eyes were of a yellowish 
red, sparkling appearance, and lent to a countenance, otherwise of 
apathy, a strange expression of wildness and horror. Black dissolved 
blood oozed from the mouth, the gums, and the nose; coffee ground 
vomit, or a dark brown flaky matter, with but little effort, was thrown 
from the stomach ; anxiety, restlessness, and great flatulency of the 
stomach, portended and accompanied its discharge, spasms seized 
the muscles ; the breathing became heavy, slow, and irregular, at- 
tended often by a hoarse, deep, sullen sound. The speech became 
incoherent ; yet, when the patient was spoken to, he appeared to be 
able to collect himself so far as to answer questions rationally, and 
although sensible of his situation, seemed resigned to his fate. These 
were the symptoms that characterized the third or last stage of the 
disease. Although all of them did not invariably occur in every 
patient, yet a sufficient number were generally present to point out 
the character of the disease to the medical attendant the moment he 
entered the sick room. 

The first stage consisted in a broken or irregular reaction ; and the 
second, or milder stage, in a general excitement diffused throughout 
the system. The duration of the first stage was generally from one 
to twenty-four hours ; and that of the second stage, from one to forty- 
eight hours. The first stage could readity be distinguished from the 
second period, by the partial evolution of heat in the one, and the 
uniformly hot surface of the other. The patient was found covered 
up with bed-clothes in the first stage, but in the second and third, he 
greatly preferred lying entirely naked. 

In a great many cases, the worst cases too, the state of the system 
which constitutes the second stage, never occurred ; but the disease 
passed immediately from the first to the last stage, without going 



MALIGNANT FEVER. 375 

through the second stage of reaction. — These were called the cold 
cases of yellow fever, or yellow fever without reaction. 

The approach of the first stage of the disease was announced by 
an intoxicated appearance, and a remarkable exhilaration or depres- 
sion of spirits, and was soon ushered in by a contemporaneous sen- 
sation of heat and cold. The patient, although complaining of great 
internal heat, was often found under one or more blankets, which 
he would not permit to be removed. His skin, which to him felt 
excessively hot, was often actually cold to the touch. Yawning, 
stretching, soreness of the flesh, achings of the bones, and, at length, 
flatulency of the stomach, with great weight and oppression about 
the preecordia, took place, followed by pain in the head, stomach, 
and back. 

The pain, in this stage, was never so severe as in that of general 
reaction. Indeed, it was sometimes entirely absent. It was re- 
marked by a very intelligent and accurate observer of the disease, 
Dr. Gustine, that the most fatal cases were those which were at- 
tended with the least pain. 

A want of thirst also attended the disease in its first stage. The 
tongue was then seldom much furred ; its edges were often red ; 
sometimes, it presented no unusual appearance in the most malignant 
cases. The patient, in this and the second stage, was as anxious 
about living, as he was indifferent and careless of life in the last stage. 

Treatment. — Experience has long since proved that the same 
remedies produce very different effects in different diseases, and in 
different stages of the same disease. Stimulants, emetics, cathartics, 
&c, are the only relative terms; for, in many conditions of the sys- 
tem, stimulants impart no strength, tartar emetic will not puke, nor 
will calomel purge or salivate. I shall first point out the state of the 
system in which they were used, the effect they produced, and the 
manner in which they influenced the disease. In all important 
cases, I was in the habit of noting the state of the system when a 
remedy was given, and on my next visit, noting also the changes 
produced in the disease. When a remedy, in any particular state 
of the system, was found to be pernicious or useless, it was not con- 
cluded to be pernicious or useless in all states of the system, but only 
under those particular circumstances in which it had been proved to 
be so. When the disease terminated fatally, I looked back on the 
situation of the patient when the remedies had been used, their ef- 
fects on the disease, and immediately proceeded to make post mortem 
examinations, and to note down every morbid appearance. Having 
the charge of Natchez hospital, from the 6th of September, until the 
epidemic terminated in November, I had an excellent field for ob- 
servation. Patients of every description were admitted, and in every 
stage of the disease, — some who had been under the treatment of 
other physicians, and others who had taken no medicine. This 
hospital, with my private practice in the city, in which I resided 
during the epidemic, and the experience of the disease in my own 



376 MALIGNANT FEVER. 

person, in the present, and also in a former epidemic, are the sources 
from which the following observations have been drawn. I have 
seen patients recover from yellow fever under very different, and 
apparently, opposite modes of treatment. The narrow view's which 
are too often formed of the action of medicines, and of the laws 
which regulate the system, aided by the dogmas of the schools, have, 
until within a few years past, shackled the science of medicine, 
and hindered its progress. Facts are yet too often overlooked or 
disregarded, when they do not support some slender-built theory, or 
favourite hypothesis. 

In the first stage of yellow fever, or that in which consists of an 
ataxic or crippled reaction, when the blood is unequally determined, 
the heat unequally-diffused, sensation impaired, and a secretion sus- 
pended, I found no other remedy, or combination of remedies, which 
produced such decided effects, as tartar emetic, in full doses. It, 
however, seemed sometimes inadequate to make a sufficient impres- 
sion on the torpid system. When given in this stage of the disease, 
its effects were not so soon apparent, as in the healthy state of the 
system, or in less violent diseases. Very often, it would be an hour 
or more, after a full dose had been taken, before the system appeared 
to feel it. At length the peculiar sensation of heat and cold , at the 
same time, would somewhat yield to a sensation of heat only ; the 
temperature of the skin would become more uniform, and as the ex- 
citement was brought out, great distress would ensue, and the sys- 
tem appeared to arouse from its torpor, and to regain, in some mea- 
sure, its organic sensibility. Some one or more of the great organs 
of secretion now took on a secretory action. The nausea, the retch- 
ing and anxiety, soon gave way to full vomiting, first of phlegm, and 
then of bile. This, to a spectator, was an alarming period in the 
disease, and most distressing to the patient. The powers of life 
would sometimes appear as if they were about to give way under it, 
but happily it was only in appearance. The vomiting at length 
subsided, and the patient enjoyed a little respite from his sufferings, 
and, bathed in a perspiration, he would fall into a slumber of short 
duration, for these were only the first effects which tartar emetic pro- 
duced on the system. Soon reaction took place, and the disease 
passed into the second stage ; but the reaction was general, and lost 
its ataxic or broken character ; it was accompanied with a hot skin, 
violent pain, and a full, strong, tense pulse. The patient would now 
complain of excessive misery. I delighted to see the disease come 
out thus openly, and show itself by fever and pain ; for, although the 
patient might fancy himself worse, yet he was far removed from the 
danger which attended on the ataxic fever from which his system 
had just emerged, and only required a bold use of the lancet, and 
other remedies hereafter to be mentioned, to restore him to health. 
But it was not always the tartar emetic, when given in the first 
stage, would produce vomiting. In those cases in the first stage, in 
which the skin was cold, and even when the reaction was ataxic 



MALIGNANT FEVER. 377 

and scarcely perceptible, the organs as if palsied, secretion entirely 
suspended or strangely vitiated, the stomach irritable, and little or no 
pain complained of, tartar emetic, in full doses, might be given with- 
out producing vomiting. Strange as it may appear, tartar emetic, in 
such cases, was a most powerful stimulous ; it brought out the ex- 
citement, heated the skin, raised the pulse, allayed the irritability of 
the stomach, restored sensibility to the organs, and finally awakened 
one or more of them, the kidneys, skin, &c.,to active secretion. To 
have this effect, it should be given in doses of from three to ten 
grains every one, two, or three hours, dissolved in a small quantity 
of water, or what is better, as I have since learned, in similar states 
of the system, in pills. When secretion has been brought about by 
the remedy used in this way, and the excitement developed, it should 
not, at once, but gradually, be discontinued, by giving smaller por- 
tions at long intervals. Should a vomiting ensue before the skin has 
its heat and sensibility somewhat restored, bile will rarely be evacu- 
ated : in this event, another dose of the medicine should be imme- 
diately given, and repeated whenever great nausea ensues. I have 
rarely seen this practice fail, in such states of the system, to check 
the vomiting and heat the skin, when mustard and blisters had 
failed. It will be remembered, that those which are denominated 
cold cases, are the most hopeless. I have used the hot bath, fric- 
tions, sinapisms, blisters, besides various internal stimulants to bring 
on reaction ; but the combined influence of all these remedies has 
never had the same beneficial effect as tartar emetic alone. But in 
some cases of this kind, particularly in hard drinkers, it fails to pro- 
duce secretion, and to develop excitement. It may be imagined by 
men in their closets, that these are cases of congestion only, which 
congestion could readily be removed by small and repeated bleedings 
combined with internal and external stimulants. If the malignant 
nature of these cases depend entirely on congestion, it is a very dif- 
ferent congestion from that which takes place in many other diseases. 
In the latter, I have often succeeded in removing the congestion, by 
blood-letting, combined with internal and external stimulants ; but 
in the cold cases of yellow fever, never. In such cases, if blood be 
taken away, even should the patient not immediately sink under it, 
so far from the reaction being produced, the blood vessels lose more 
and more of their contractile power ; stimulants impart no strength ; 
the warm bath and rubefacients produce no more effect on the skin 
than if applied to so much leather ; the organs become more para- 
lyzed ; the sympathies more deranged ; and the whole system soon 
appears as if it were divided into two different parts, one not depend- 
ing on another, and each having the principle of life diminished in 
it. Instead, then, of using blood-letting in such cases, to remove 
congestion, I used tartar emetic to produce secretion, and to develop 
the excitement. Although tartar emetic was sometimes inadequate 
to produce these desirable effects in the cold cases, it scarcely ever 
failed to be eminently serviceable in the first stage of cases o( a less 



378 MALIGNANT FEVER. 

malignant nature. The earlier it was given in the first stage of the 
disease, the better. When given freely, so as to produce secretion in 
the liver, kidneys, and skin, a general and equable reaction soon 
succeeded. It shortened the duration of the first stage, or that of 
ataxic reaction, and thereby converted a highly malignant into a 
mild case of yellow fever. For, in the mild cases, when left to na- 
ture, the first stage continues but a short time, and the disease soon 
passes into the second, or that of general reaction. These are the 
cases which bear bleeding and purging so well, and in which eme- 
tics are of no service, (unless given before the general reaction has 
taken place.) The good effects of emetics appear to depend on their 
ultimately producing a general and equable excitement throughout 
the system. In the more malignant forms of yellow fever, the stage 
of ataxic reaction, when left to nature, continues a longer time ; and 
should the second stage, or stage of general excitement ever occur, 
its duration is so limited, that a sufficient time is not given to subdue 
the disease, before it passes into the third and last stage. Tartar 
emetic, then, given in the first stage, shortens its duration, and places 
the system in a similar state to what we find it in the milder forms 
of the disease. And, in proportion as the ataxic stage is shortened, 
so is the stage of general excitement prolonged, and the chances of 
the patient's recovery greatly increased. 

On looking over my notes, I perceived, that when it had been 
given in the first stage, such patients not only bore bleeding better, 
and could be purged more easily, than those to whom it had not 
been given ; but whether they lived or died, the symptoms of the 
second stage, or that of reaction, continued longer than when tartar 
emetic had been omitted. — For in those cases in which it had not 
been given, should the stage of reaction ever occur, it continued but 
a short time, frequently not more than an hour ; then external reac- 
tion, like the blaze of recently ignited coals, would subside, not from 
the fire having been extinguished, but from the heat which supported 
it having become greater. My notes, likewise, showed me that tar- 
tar emetic, however well adapted to some states of the system, was 
not so to every one in yellow fever. For when it had been given 
in the stage of general reaction, its effects were extremely equivocal, 
and, in some cases, injurious ; and in the third stage, it appeared to 
accelerate the fatal black vomiting. I thus found that I had pushed 
a favourite remedy too far, by using it improperly ; and, at the same 
time, learned the particular states of the system to which it was 
peculiarly adapted ; namely, during the first stage of the disease, 
antecedently to the development of a general reaction. Tartar eme- 
tic used in this stage, restored sensibility to the torpid organs, pro- 
duced secretion, and destroyed the ataxic character of the disease, by 
establishing a general and equable excitement ; or, in other words, 
converted an irregular and intractable condition of the system, into 
an open, plain, and manageable case of fever. When I first treated 
yellow fever, in its first stage, by tartar emetic, and witnessed the 



MALIGNANT FEVER. 379 

violent reaction that shortly succeeded its use, and heard the ago- 
nizing shrieks of my patients, from the pain that attended the 
increased sensibility and universal excitement that succeeded it, 
for a moment I thought I had done wrong, and would have 
ceased to use it, had I not found that this was the only state of 
the system in which the lancet could fearlessly and successfully be 
used. Even when the lancet was not used, the general reaction in- 
duced by tartar emetic, was nothing like so fatal, as when an ataxic 
state cloaked the violence of the disease. To illustrate this remark, 
Dr. McPheeters, lately from Missouri, was taken ill at the most peri- 
lous and alarming period of the epidemic. He found himself alone, 
and rendered helpless, by a violent disease that killed generally in 
three days. Being a man of great strength and energy of mind, he 
resolved to make use of efficient measures, and, accordingly, mixed 
up sixty grains of tartar emetic, and took a sixth part of it at once. 
It proouced copious secretion, and was soon followed by a vehement 
excitement of the whole system. Having no means to subdue the 
reaction thus brought about, it ran its course. But, every part being 
excited, the system was enabled to bear up against a power that oth- 
erwise would have caused it to succumb. Nine or ten days after- 
wards, I visited him. Reaction had nearly run itself down. He 
looked more like a patient in the advanced stage of a common syno- 
cha, than one in the yellow fever. Had not the ataxic reaction, 
with which the disease commenced, been removed, he would not, 
most probably, have survived. 

Blood-letting. — If blood-letting were resorted to before the 
development of general reaction, the reaction, which had yet only 
partially developed itself, abated ; the heat which had begun to 
spread itself over the surface, disappeared ; and the pain would sub- 
side ; and this, too, before the quantity of blood taken away was, in 
any degree, considerable. Medicines did not operate, and the dis- 
ease at once passed into the last stage. During the ataxic reaction, 
in vain may we be told to bleed to the relief of the symptoms ; foi 
they grow worse while the blood is flowing, and continue to become 
more alarming, and that in proportion to the quantity of blood taken 
away. 

When a feeble and broken reaction has taken place, to attack it 
by the lancet, is like attacking the first phalanx of an enemy, when 
he attempts to come out of his intrenchments, instead of waiting 
until the main body has appeared in the open field. But in the 
second stage, in which the heat of the whole surface is excessively 
increased, the pulse full and strong, the patient lying naked, and 
calling on the attendants to fan him, and to give him cold water, we 
may bleed fearlessly and successfully. The effects produced on the 
system by blood-letting in the reacting, so far from hastening the 
disease into the last stage, and bringing on fatal symptoms, prevented 
it from passing into that state, and robbed it of all its violence and 
danger. I will now give a case in which bloodletting was followed 



380 MALIGNANT FEVER. 

by alarming consequences, from its being used a little too soon in the 
disease ; that is, before the second or reacting stage has fully deve- 
loped itself, yet so near the stage of general reaction, as to prevent 
blood-letting from proving fatal. Mr. McCauley, a printer, was 
attacked with yellow fever, on the 20th of August. The disease 
appeared at once to overpower the system. It seemed as if the vis- 
cera had absorbed nearly the whole of the circulating fluids, as the 
skin was cold and almost insensible ; the pulse small, slow, and 
weak, and no secretion appeared to be taking place from any organ 
whatever. He complained of no pain, yet was restless and uneasy, 
and seemed to be oppressed in his breathing, as if a heavy body 
were lying across him. In this situation, early in the morning of 
the 21st, about twelve hours after his attack, a full dose of tartar 
emetic was given him. In two hours afterwards, he began to com- 
plain of pain in his head and back ; his skin became sonjewhat 
warm, particularly about the head and breast ; frequent efforts were 
now made to vomit, but nothing except the drinks was evacuated : 
a clammy sweat bedewed his forehead and breast, which soon dried 
up, and again appeared. He continued in this state until noon, 
when full vomiting took place. At two o'clock, the vomiting ceased, 
and the irritability of the stomach was so much allayed, that it re- 
tained several doses of calomel and castor oil, senna, tea, &c, which 
were given at regular intervals, until seven o'clock ; and, although 
assisted by injections, had not operated. He now complained of 
excruciating pain. His skin, except his extremities, was hot to the 
touch ; his pulse at the wrist tense, but not full and strong. The 
ataxic reaction was verging on to general reaction ; but the latter 
had not, as yet, fully developed itself. Hoping that it would be the 
means of making the medicine operate, I opened a vein in the arm; 
as I never feared blood-letting in such states of the system, as, alone, 
it would either produce secretion, or cause medicines to do it. 

Being determined to bleed him until some sensible effect was 
produced, I took away upwards of sixty ounces of black dissolved 
blood, before the system seemed to feel its loss. The blood was 
stopped, in consequence of a slight sickness at the stomach. The 
patient answered several questions after I had tied up his arm. I 
went into an adjoining room, and, in about five minutes, was told 
the patient was dying. I took hold of his arm, but found no pulse. 
His face was sprinkled with water, washed with vinegar, and con- 
stant frictions applied to the skin during fifteen minutes, yet without 
effect. — Some laudanum was now procured, and one hundred and 
twenty drops poured down his throat. After waiting fifteen minutes 
longer, for a boy to return from the apothecaries, half an ounce of 
spirit of hartshorn was given, which he seemed not to feel. A stimu- 
lating injection was administered ; his face was washed with the 
aqua ammonia, and the frictions were kept up. All of his atten- 
dants, excepting one, left him, and reported him dead. I thought, 
myself, that animation had been suspended too long, in his present 



MALIGNANT FEVER. 381 

condition, to be restored. After remaining in this situation for nearly 
an hour, signs of life again appeared. After several sighs, respira- 
tion took place, and a tremulous pulse was felt. But from the 
slightest exertion on the part of the patient, synocope would again 
ensue, and continue for several minutes. I ordered the spirits of 
turpentine to be freely given, stimulating injections to be used, and 
sinapisms to be applied to the extremities. 

On the morning of the 22d, I found that no perceptible secretion 
had taken place : he had neither sweated, urinated, or had an eva- 
cuation from his bowels. Suspecting that there might be a want of 
power in the bladder to evacuate the urine, I examined, but found 
no urine in the bladder. I continued to give the turpentine, in 
drachm doses, every hour through the day. His bowels, on the 
evening of the 22d, acted ; and, shortly afterwards, he discharged a 
little very turbid urine. On the morning of the 23d, the great organs 
of secretion were all awakened, and the patient, though much ex- 
hausted, was, in a few days, restored to perfect health. Had the 
reaction in this case been general, and not of the ataxic kind, I judge 
from what I have seen in other cases, that no alarming effects would 
have followed the use of the lancet ; but had not the ataxic ap- 
proached so nearly to general reaction, I am fully persuaded that the 
patient would not have borne half the quantity of blood to have 
been taken away, without producing death. I have dwelt the longer 
on this case, as the length of time which elapsed before the emetic 
operated, the changes that took place in the system in consequence 
of it, the great quantity of blood that was taken away before the 
system felt its loss, the alarming effects that followed it, and the 
length of time before the torpid organs assumed a secretory action, 
are well calculated to show the character of the most malignant form 
of yellow fever, and the manner in which they are influenced by 
remedial agents. I will now give one case, out of many, to show 
the effects of blood-letting after the excitement is fully evolved. 
Mr. Welch, a baker, was attacked with yellow fever on the 15th of 
September. On my visiting him, on the morning of the 16th, 1 
found him wrapped in several blankets, and complaining both of 
heat and cold. I ordered five grains of tartar emetic every hour, till 
he vomited copiously. In the evening, I found him lying naked on 
the floor, as the bed was too warm ; he was raving like a madman 
from the excruciating pain in his head and back ; he begged the 
attendants to kill him at once, and put him out of his misery. His 
pulse was full and strong, and the whole surface of the body re- 
markably hot. — I took away, at one bleeding, six pints of blood, 
before the symptoms were relieved. He continued very sick at his 
stomach only for half an hour, but did not faint. Calomel and cas- 
tor oil, then given, operated freely on his bowels in six hours after- 
wards, and he speedily recovered. 

In my own case, I lost four pounds of blood at one time. It was 
taken away before general reaction had as fully developed itself as 



382 MALIGNANT FEVER. 

I could have wished. A most distressing feeling of exhaustion en- 
sued, and continued for an hour or two. No healthy secretion took 
place for twenty- four hours afterwards; at the end of which time, by 
a judicious course of treatment pursued by my physician, and friend, 
Dr. Kenny, the skin, the liver, the kidneys, and salivary glands, all 
took on a secretory action ; and in less than a week from my attack, 
I was able to leave my room ; and in two or three days more, I 
resumed my practice. It was not until I had seen some of the most 
injurious effects from the loss of the smallest quantity of blood in the 
ataxic stage of the yellow fever, that I could be convinced of the 
propriety of waiting until the excitement had fully developed itself, 
before recourse should be had to the lancet. 

Purgatives.— If purgatives were given immediately on the ac- 
cession of the first stage, they sometimes produced secretion, which 
was followed by a reaction more or less general. But it was only 
in the milder forms of the disease, in which the organic sensibility 
was not greatly impaired by the first shock of the disease, that pur- 
gatives produced secretion. Drastic purgatives, in almost any state 
of the system, would, after so long a time, force away watery stools, 
which, like similar secretions in cholera morbus, soon exhausted the 
system, without producing any beneficial effects whatever, either 
immediately or remotely. 

When the system was placed in a proper state for the exhibition 
of purgatives, those of the milder class would be followed by bilious 
discharges, which were beneficial; but when it was not in this state, 
drastic purgatives would produce serous mucus, or sanguineo-serous 
discharges, which were extremely injurious. As the milder cathar- 
tics were found to have all the good of die drastic, and none of their 
evil effects, I preferred mild to drastic purgatives. Late in the epi- 
demic, I obtained some of the Croton oil. From the trials I gave 
it, I am induced to believe that it will be found to be a valuable 
remedy in many cases of yellow fever. Every time it was used, 
copious bilious dejections ensued. It was, however, only resorted 
to in those states of the system in which I would have used other 
purgatives. As this medicine is so pleasant to take, and can be 
retained on the stomach in cases in which almost any other purga- 
tive would be rejected, it promises to be of great utility in many 
forms of disease. 

Mercury. — Given in the first stage of the disease, mercurial pre- 
parations in, by far, the majority of cases, produced no evident effect 
on the system, and, consequently, none on the disease. Sometimes, 
however, even in this stage, they produced ptyalism, yet such ptyal- 
ism had little or no effect in arresting its progress. 

There is a state of the system which, however, occurs more often 
in bilious than in yellow fever, in which I have found the specific 
effects of mercury to be particularly serviceable. After reaction has 
subsided, and the skin, kidneys, and liver have been excited into a 
secretory action — owing to some organ having, from some cause or 



MALIGNANT FEVER, 383 

other, sustained a great shock, a torpor will again take place in one 
or more of these organs, that produces great irritation in the system, 
preventing sleep, destroying the appetite, producing fever, and there- 
by exhausting, more and more, the already too much exhausted 
patient If the torpid organ be excited into action by any other 
remedy than mercury, as soon as it ceases to feel the impression of 
the remedy, it ceases to secrete : here, mercury, by keeping up an 
impression not transient, as the most of other medicines, but per- 
manent, will, by enabling the diseased organ to regain its powers, 
restore the patient to health. In the above state of the system, and 
in many others in which the specific effects of mercury are indicated, 
I had been taught to use Calomel in small and frequently repeated 
doses ; but experience has convinced me, that there is scarcely any 
state of the system, requiring the specific action of mercury, in which 
calomel, in large doses, is not the best means to effect it. Scruple 
doses of this medicine will not only induce the specific effects of 
mercury sooner, but will be followed by fewer disappointments, and 
less inconvenience and danger, than when smaller doses of that 
medicine, or any other form of mercury, have been resorted to. 

Diuretics. — As a copious secretion of urine was a favourable 
symptom, and a suppression of it alarming, and often fatal, diuretics 
were remedies, in many cases, of great importance. When purga- 
tives would not produce a secretion of bile, instead of trying by re- 
iterated doses of these medicines, more especially of a drastic nature, 
to force away alvine discharges, which, in such circumstances, would 
generally be of a serious kind, that tended only to weaken the pa- 
tient, I endeavoured to excite the kidneys to secretion by diuretics. 

I have often had the pleasure to find that the urinary secretion 
produced by them, was of equal advantage in arresting the progress 
of the disease, as the biliary, by purgatives. Soon after the secre- 
tion of urine was established, the skin and liver would both gene- 
rally begin to yield their peculiar secretions, and the disease would 
no longer be able to resist the efforts of these allied organs. 

Diaphoretics. — When neither the liver nor kidneys could be 
excited into action, diaphoretics were sometimes serviceable. But 
great irritability of the stomach, the distaste to all medicines, the 
want of nurses, and the rapid march of most cases, prevented me 
from encumbering my practice by such feeble medicines, in the 
treatment of a disease, which seemed to require only a few simple, 
efficient, and well timed medicines. 

Epispastics. — In every stage of the disease, I have used blisters, 
applied to the head, over the stomach and bowels, to the extremities 
and down the spine. The benefit, however, which I had reason to 
expect from my experience with them in bilious fevers and other 
diseases never followed their use. Sinapisms to the extremities, to 
assist tartar emetic, and the hot bath to produce reaction in the cold 
cases ; or after reaction had been reduced, to stimulate the prostrated 



384 MALIGNANT FEVER. 

patient, were far more serviceable than blisters. The former acted 
much more quietly, and produced greater pain than the latter. 

Stimulants. — How the bark and wine in large doses would 
have answered in the first stage of this disease, to change the ataxic 
reaction of that stage into a general reaction, I cannot from expe- 
rience determine. 

The Spanish practice in the Andalusian fever, consisted in large 
and repeated doses of bark, given immediately when the patient 
began to complain. This practice, we are told by Dr. Johnson, 
was attended with extraordinary success. I very much suspect that 
the good effect of bark, in that fever, principally depended on its 
transforming the broken excitement, with which the disease com- 
menced, to a general reaction, or open case of fever. I lost one 
patient who drank a draught of ardent spirits, with pepper in it, 
immediately after the attack. 

The fever became developed, but great gastric distress attended 
throughout its course. Autopsic appearances proved the existence 
of unusually high inflammation in the stomach. 

Of the Bath. — The cold bath, if used in that state of the sys- 
tem, which I have called ataxic reaction, was evidently injurious. 
I cannot better describe its effects, than by the following case : — 
Mrs. Rice, in the first stage, used ablutions of cold water and vinegar. 
The efforts made by the system, towards general reaction, became 
immediately subdued; and, to use her own language, "the cold 
water drove the fever in upon her heart and stomach." Great cold- 
ness and shivering, with internal heat and oppression, succeeded its 
use. Reaction never took place, and the disease passed, at once, 
into the last stage ; and when I was called to see her, fatal symptoms 
had appeared. Had an emetic, instead of the cold ablutions, been 
tried, it is probable that reaction would have been general ; would 
have borne blood-letting, and have been attended with a different 
result. The only condition of the system, in which cold ablutions 
or affusions were advantageous, was when the surface was uniformly 
and pretematurally hot. In this epidemic I never found any dif- 
ficulty in reducing the reaction by the lancet and other remedies, 
consequently, I seldom found it necessary to call in the aid of cold 
affusions. 

In the yellow fever under review, when reaction was reduced, or 
on the wane, if secretion did not take place, the tepid bath, appa- 
rently by removing the remains of morbid heat, and by restoring the 
natural sensibility of the skin, enabled that important organ to take 
on a proper secretory action. But cold water, by carrying off too 
much heat, reduced the temperature of the skin below that degree 
which is compatible with natural sensibility; and, consequently, 
with healthy secretions. Pleased with the effect of the tepid bath, 
after the use of the lancet in the reacting stage of the disease, I re- 
sorted to the same remedy in the ataxic stage. The temperature of 
the bath was 96 degrees. The patient, as soon as immersed, com- 



MALIGNANT FEVER. 385 

• 

plained of being disagreeably cold ; he was taken out in a shivering 
fit, and was shortly afterwards immersed in a bath so hot, as to be 
extremely painful to my own hands, yet he did not in the least com- 
plain of it. His skin soon became generally warm, and an emetic, 
which he had previously taken, began now to operate. He was 
removed from the bath, and in a few hours a fever so violent ensued, 
that copious blood-letting was employed to subdue it. The hot 
bath, whenever it could be procured, was employed in conjunction 
with emetics, in the cold cases of yellow fever, in order to bring 
about a general reaction. If emetics were not used in conjunction 
with the bath, the skin, it is true, would be heated : but its heat, 
like that of an inanimate substance would soon subside on being re- 
moved into a colder medium. 

Dr. Cartwright farther states, that he personally witnessed the 
yellow fever of 1825 in Natchez, " Under the Hill;" in Washing- 
ton, a village six miles from the river Mississippi ; at Haughton's, a 
tavern in the country; and, lastly, in Natchez, " On the Hill;" and 
he proceeds to give the following additional facts relative to the 
causes, nature, and treatment, of the disease, which its occurrence 
and prevalence in the above mentioned places afforded him an op- 
portunity of observing. 

Natchez Landing, (or Under the Hill, as it is called,) consists of 
a few rows of buildings, situated immediately on the brink of the 
Mississippi river, at the foot of a bluff about two hundred feet high, 
which forms the site of the principal part of the city, called Natchez 
" On the Hill." Although during high water, the buildings under 
the hill are immediately on the brink of the river, yet when the river 
falls, as it always does in summer, a surface of ground several rods 
in width, becomes uncovered between the buildings and the river. 
The surface thus exposed by the falling of the river, consists of mud 
recently deposited, and of the debris of various vegetable and animal 
substances, which, during the season of trade, had been thrown out 
by the flat boats that landed at this place. On the margin of this 
uncovered surface, there is a warehouse, which, in the months of 
July and August, 1825, contained a large quantity of spoiled porter 
and sour pork. The owner of the warehouse was constantly en- 
gaged in repacking the pork ; the brine from which, was permitted 
to run through the floor, into a kind of cellar, which had no outlet 
to it. Some of the porter barrels burst, and the spoiled porter, also, 
ran through the floor into the cellar, with the brine from the sour 
pork. Some few hundred yards above the warehouse, there was a 
boat containing a quantity of rotten corn, which had been sunk in 
the water, but became exposed in the summer by the falling of the 
river; and below the warehouse, but not so far from it, there were 
two or three houses that contained stagnant water, others, putrid sour 
krout, fish, oysters, &c, in their cellars. 

Leaving Natchez for the present, I proceed to Washington, to give 
49 



386 MALIGNANT FEVER. 

• 

a brief sketch of its topography, and an account of the epidemic 
yellow fever, which prevailed there in the autumn of 1825. 

Washington, a small village, containing about four hundred in- 
habitants, is situated six miles east of Natchez, and not less than the 
same distance from the nearest point of the Mississippi river. The 
town occupies a high and healthy situation, remote from any swampy 
ground, or from any water-course whatever, except a small stream 
of running water, a branch of the St. Catherine's, about a quarter 
of a mile north-east of it. The citizens of Natchez, prior to 1825, 
always found Washington to be a place to which they could retreat 
with safety, from the ravages of the malignant fever. The in- 
habitants of that town had hitherto opened their doors to the sick 
and the dying, and received no harm, as not a case of yellow fever 
ever occurred among those who had not breathed the Natchez 
atmosphere. 

A grocer, who had been living " Under the Hill," removed his 
grocery store to Washington in. the latter part of the summer. He 
rented an old wooden house on the north side of the main street, 
which, with the lot attached to it, is situated in the hollo w space of 
ground described above. The earth had been thrown up around 
the palings of the lot, except at one place, to serve as a drain in 
rainy weather. This drain was choked up with weeds and trash 
when I examined it, during the progress of the epidemic about to be 
described, and served but imperfectly the purpose for which it w r as 
intended. The grocer who removed his store to the house on this 
lot, removed also a quantity of bacon and mackerel, a great part of 
which had begun to putrefy at the time of its removal, or putrefied 
soon afterwards. These provisions the grocer was in the habit of 
selling to negroes. Mr. Alfred RadclirT informed me, that a few days 
before the yellow fever originated in Washington, he called on the 
grocer, in order to purchase some bacon for a friend in the country ; 
but on examining it carefully, the whole quantity which the grocer 
had on hand, was found to be in a putrescent state, and none of it 
fit to purchase. About two thousand pounds of bacon, he stated, 
was filled with large worms, and was in a putrid condition. 

The Rev. Mr. Burruss informed me, that in addition to the putri- 
dity within the house, the grocer was in the habit of receiving from 
the fishermen on the Mississippi river, supplies of fresh cat-fish, (a 
fish in this river weighing from ten to one hundred pounds,) the 
heads and entrails of which, besides what rotted on his hands, were 
thrown into the back yard of the lot above described. All I person- 
ally know with respect to the real situation of the grocery, is what 
every person knows, who either lived near, or came in its vicinity, 
that the stench from it was extremely disagreeable. The principal 
stores and boarding-houses in town, were situated a short distance 
from the grocery, both above and below it. Both of the town mar- 
kets were within twenty-five steps of it. Should it then be a matter 
of wonder, if a few persons living in the suburbs of Washington, in 



MALIGNANT FEVER. 3S7 

the most healthy situations, should have been attacked with yellow 
fever, a little after the time it broke out around the grocery, when it 
is recollected that those who visited the stores, the taverns, and the 
markets, were exposed to the same atmosphere with those residing in 
the vicinity of the grocery ? 

The yellow fever of Washington, like that of Natchez, in 1823, 
had three stages. The first stage was generally preceded by, and at- 
tended with, catarrhal symptoms. It was known by the patient's 
sensations being no true evidence of the actual coldness or heat of 
his surface ; by the heat of the surface being unequally diffused, the 
head and breast hot, the extremities often cold ; by the patient pre- 
ferring to be wrapped up in* blankets, although, at the time, his skin 
may have been pungently hot to the touch, by the chilly feeling 
being greatly increased, if the patient merely reached out his arm to 
have his pulse felt, or if any of the bed-clothes were removed, al- 
though he might have complained of these making him disagreeably 
hot, by a copious perspiration occasionally taking place, and drying 
up without relieving the disagreeable chilly feeling, abating the pun- 
gent heat of the skin, equalizing its evolution, or establishing the 
lost relation between the patient's feeling of heat, and the real heat 
of his body. So different were the sensibilities, both organic and 
animal, in this fever, from a healthy condition of the system, that I 
have known patients to complain of their extremities being cold as 
ice, when they were actually burning hot. I was forcibly impressed 
with this fact, on seeing patients bear to their extremities, particularly 
their feet, applications sufficiently hot to corrode or blister the skin, 
and produce great pain, were not the organic and animal sensibility 
of the part very different from health. I recollect having affronted 
one person, from having him put in a tub of water, disagreeably hot 
to my hands, not because he found it too hot, but too cold. The 
second stage was known by the patient losing all his chilly feelings ; 
by his throwing off the bed-clothes, calling for cold drinks, being- 
tortured with the severest pain in his head and back, tossing himself 
from side to side in his bed, or going from one bed to another, by 
his uniformly hot surface, by a diminution in the secretory process, 
to wit : a paucity of bile and urine, great dryness and heat of the 
skin, and mucous membranes, and, lastly, by an increased energy 
of the whole arterial system. The third stage was pointed out, by 
the heat of the surface having diminished, but not the patient's sen- 
sation of heat having proportionally diminished, by a slow irregular 
respiration, or even when the number of respirations differed but 
little from the healthy state ; by the yellow skin, accession of strength, 
the black vomit, and hemorrhages from the mouth and nose. 

The first stage, in some cases, quickly passed into the second; in 
others, it continued twenty four, or even forty-eight hours, before the 
reacting stage ensued. This stage, in some, never occurred, the dis- 
ease passing at once from the first to the last stage, while in others 
badly managed, it lost many of its characteristic features ; namely : 



388 MALIGNANT FEVER. 

there would be great heat, thirst, and pain, yet a quick irritable 
pulse, which would not bear the lancet ; a comatose state of the 
brain, similar to typhus fever, accompanied with extreme irritability 
of the stomach, and a strong disposition in the bowels to take on a 
watery purging. Such cases were very fatal. The disease, not 
only in Washington, but in Natchez, the present season, differed 
from that of the latter place in 1S23, in its very great liability, in 
many cases, to be attended with copious and vitiated secretions, not 
only in its first, but in all its stages. 

Treatment. — As in 1823, during the first stage, or that of ataxic 
reaction, tartar emetic was found to be the most useful remedy. I 
generally gave from six to ten grains at a dose, and repeated it in 
smaller doses, until it either produced bilious emesis, removed the 
chilly feeling, developed an excitement throughout the system, pro- 
duced secretion in the skin or kidneys, subdued the ataxic fever, or 
palsied the deranged organic actions. Vitiated secretions seemed to 
depend on the latter, as, in many cases, the first doses of tartar eme- 
tic put a stop to the vomiting of a vitiated fluid, which had taken 
place before its exhibition. Tartar emetic, however, used in small 
and repeated doses, often rendered the stomach more irritable, and 
even when used in effectual doses, it often did harm, unless properly 
managed. When the chilly sensation was very great, the warm or 
hot bath, if used a little before, or at the time, the emetic was given, 
enabled it to produce bilious reaction, much more readily, and with 
much less distress to the patient, than when the emetic had been 
trusted to alone. 

Case. — Mr. K., of Natchez, was violently attacked. He told me 
to give him any thing but tartar emetic; for it always cramped him, 
produced great coldness, and he had, every time he had taken it, 
come near losing his life. His life appeared to me to depend on a 
bold use of the remedy he so much dreaded, as I had no hope of 
subduing so violent an attack, unless some great change could be 
produced in his system by the remedy in question. As his kidneys 
were torpid, I gave him freely of gin sling, had him put into a hot 
bath, to remove the chilly sensation he complained of, and gave 
him, while in the bath, ten grains of tartar emetic in half a pint of 
strong seneca tea. He vomited bile copiously and easily ; and so far 
from requiring hartshorn, laudanum, &c, to remove the coldness 
and cramp, as formerly, he soon lost near two pounds of blood, to 
subdue the consequent arterial reaction. He soon recovered. From 
Dr. McPheeters, I learned the efficacy of black mustard in vinegar, 
both as an emetic itself, and as a powerful coadjutor of tartar emetic, 
in cases wherein the latter alone, from torpor of the stomach or some 
other cause, failed to awaken the energies of the system. Warm 
brandy-toddy, in some cases, prevented the tartar emetic from pro- 
ducing vitiated secretions, and at the same time enabled it to produce 
those of a proper kind, or at least enable it to prepare the system for 
their production. As cold feet and hands had a great effect in 



MALIGNANT FEVER. 389 

opposing the beneficial action of tartar emetic, warm pediluvia, si- 
napisms, frictions, (fee, were found to be necessary to place the sys- 
tem in a proper condition for its reception. It was always necessary 
to subdue by the lancet, general arterial reaction or fever, whenever 
it came on, as it sometimes did, before bilious vomiting, had been 
produced. If it were a broken reaction or fever, however, tartar 
emetic was its best febrifuge. Great determination of blood to the 
head, in the ataxic stage, with a pulse at the wrist, which will not 
indicate blood-letting, while at the same time there is a very strong 
pulsation of the carotid arteries, so far from being a state of the sys- 
• tern that contra-indicates tartar emetic, is the very state of the system 
in which I have witnessed more beneficial effects from the remedy 
in question, than any other whatever. I am not the only one who 
can bear testimony of the beneficial effects of tartar emetic in such 
states of the system. Dr. McPheeters has kept a record of a great 
number of cases of this kind, wherein emetics were found to be no 
less useful than the bark in intermittent fevers. If the pulse, at the 
wrist, and other circumstances, do not forbid blood-letting, this, of 
course, should be premised, previously to the exhibition of the 
emetic ; but when this is not the case, the blood-letting should be 
deferred until after the remedy has produced a change on the de 
ranged organic sensibility of the system, broke up the irregular de- 
terminations of blood, and brought out a general reaction of the arte- 
rial system. 

The worst consequences sometimes occur from a timid use of 
tartar emetic, from giving it in too small doses, repeated at too long 
intervals, or from discontinuing its use on the first appearance of any 
unpleasant symptom, at a time when it may be most needed. 

Case. — Col. Marschalk, a very large, corpulent man, was attacked 
with the yellow fever of Washington : I gave him an emetic in the 
ataxic stage of his fever. In a few hours afterwards, I was called in 
great haste to see him. He was panting for breath, as if in a fit of 
asthma. No bilious vomiting had yet been produced. Great heat, 
pain, and inward distress, were complained of. I bled him about a 
pint, as his pulse would bear no more, and gave him three grains of 
tartar emetic every half hour in spirits eeth. nitr. The second or 
third dose brought on effectual vomiting, attended with no distress: 
the skin became moist ; the difficulty of breathing, internal heat, 
pain, and distress, were removed, and the patient recovered without 
farther difficulty. 

But it behooves rne to state, that the ivorst effects are sometimes 
produced by tarter emetic rashly persisted in, without regard to the 
condition of the patient, in order to bring about some particular ef- 
fect on the system; as, for instance, bilious vomiting. But who 
has not witnessed the worst effects from cathartics, or from mercury, 
rashly persisted in, without regard to the condition of the patient, 
in order to bring about some particular effect on the system ; as, for 
instance, dark bilious stools, or a discharge of saliva 9 



390 



MALIGNANT FEVER. 



By an emetic properly managed, if given early in the disease, not 
only the fever of Washington, but that of Natchez, was often cut 
short at once, and the patient recovered without farther trouble : 
while the mildest attacks, if left to nature, ultimately seldom failed 
to prove fatal. If the disease did not yield at once to emetics, gene- 
ral arterial reaction ensued in the most of cases, requiring the lancet 
for its reduction, together with purgative medicines, which brought 
on bilious evacuations, that soon relieved the patient. Sometimes, 
however, when emetics had not been used at a period of the disease 
sufficiently early, or, if used, had not been properly managed; or, if 
properly managed, owing to some peculiarity of the case, had not 
produced their general beneficial effects on the system ; but, most 
generally, when emetics had been entirely omitted, it was difficult 
to produce, by purgatives, the proper J$ind of evacuations from the 
bowels — I mean evacuations of a dark bilious matter of tolerable 
consistency. In such cases, it was very difficult to retain purgative 
medicines on the stomach, owing to its irritability; and, if retained, 
even calomel would often produce watery evacuations. In such 
cases, to continue the use of this or any other purgative remedy, 
without first altering that condition of the system on which the wa- 
tery evacuations depended, was to continue to use them to the de- 
struction of the patient. In as much as he became speedily exhaus- 
ted under such evacuations, I made it a rule to check them by an 
enema, of a tea-spoonful of laudanum in a little starch gruel, or by 
giving opium or its tincture. The next object was to alter that mor- 
bid condition of the system on which the watery or vitiated secretions 
depended. Tartar emetic, either with or without the addition of a 
little opium, in two or three grain doses, every one, two, or three 
hours, calomel with two or three grains of opium, or with ten or 
twenty grains of camphor, repeated according to circumstances, and 
assisted by the warm bath, blistering, (fee, were often found useful 
in preparing the system to be properly acted on by purgatives. A 
remedy, however, which appeared to suit some cases the best, w r as 
the sulphate of quinine, or, where the stomach would bear it, the 
Peruvian bark with cream of tartar and cloves ; either of which was 
given without regard to fever, if such fever would not admit of 
blood-letting. Even when the fever, (I mean heat of skin, &c.) 
was increased under this practice, the various organs of the system 
became more disposed to take on a proper secretory action, than be- 
fore such fever had been excited. I am confident that I used the 
sulphate of quinine in too small doses in our late epidemic. Dr. 
Perrine assured me, that in the bilious fever in the country, ten or 
fifteen miles from Natchez — to prevent a watery purging, which so 
often took place in that disease, he resorted, after having premised 
sufficient blood-letting, to the use of the sulphate of quinine in eight 
grain doses, every two hours through the day, notwithstanding the 
presence of fever, and at night gave aloes, scammony, and calomel 
in pills, still continuing the sulphate. He assured me that under 



MALIGNANT FEVER. 391 

this free use of the sulphate, the fever would abate, and the cathartic 
would produce thick, copious evacuations of a dark colour, which 
would soon relieve the patient; whereas, to use the purgatives with- 
out the sulphate of quinine, if they operated at all, they only pro- 
duced watery stools, which soon robbed the patient of his strength, 
and aggravated his disease. Dr. McPheeters and myself have both 
used, with a similar intention, the sulphate of quinine, after the plan 
of that excellent physician, Dr. Perrine, and we have found it even 
to surpass our expectations. The purgatives which could be the 
most relied on, in the epidemic of 1825, to produce bilious secre- 
tions, were calomel, aloes, and scammony combined, the purified 
spirits of turpentine, and the Croton oil. When there was much 
pain in the bowels, accompanied with tenesmus, the charcoal was. of 
great service. The best plan of giving medicines in cases of great 
irritability of the stomach, which neither sulphuric ether, opium, ef- 
fervescing mixtures, &c, will allay, has heretofore been with me a 
desideratum in practice. The fate of a patient frequently depends 
on minutiae, too often unattended to in practice. It is an easy mat- 
ter to prescribe aloes, scammony, jalap, &c, in order to purge a pa- 
tient, who is constantly sick at his stomach. But the object of the 
prescription is often entirely defeated, in consequence of the patient 
refusing to take these remedies ; or, if he takes them, by the impos- 
sibility of his being able to retain them on his stomach. The best 
plan I ever tried, of giving these, and similar nauseous medicines, so 
as to obviate the inconvenience of their disagreeable taste, and to 
prevent them from being vomited, is to have the various purgative 
articles made into a soft mass with syrup. Any given quantity of 
this mass, is to be enclosed in a very thin wafer, made of flour, and 
softened by being soaked a few minutes in water or milk. The en- 
closed mass is then put into a spoon with a little water in it, out of 
which the patient is to swallow it. After this manner, a patient can 
take, at one dose, a mass sufficient to make a dozen pills, and he 
cannot, without the strongest efforts, throw it up from his stomach ; 
he tastes nothing but the flour wafer, and the nausea of his stomach 
is not increased, as it would be from his swallowing a quantity of 
bitter pills. In this way, a large quantity of Peruvian bark may be 
giving at a dose, without the patient's tasting it. One table- spoonful 
of flour, made into a batter with water, is sufficient to make sixty 
wafers. The plan of making them is, to have two smoothing irons 
heated, one of which is to be placed with its face upwards, on which 
a few drops of the batter is to be poured, and the other iron is then 
to be pressed upon it. The little cake or wafer, thus made, is, as I 
before observed, to be soaked in water, before using it, in order to 
make it sufficiently pliant to enclose the medicine. I venture to 
assert, that whoever tries this plan of giving nauseous drugs, as aloes, 
&c, in cases of great irritability of the stomach, will seldom proscribe 
them in pills, syrup, or solution : calomel, however, can be very 
conveniently given, floating on a table -spoonful of common cold wa- 



392 MALIGNANT FEVER. 

ter. A table-spoonful of water will float two scruples, if the calomel 
be not in lumps, and if it be sifted down lightly on the water. Spi- 
rits of turpentine should be purified by mixing it with alcohol, as di- 
rected by Dr. Nemmo. With these remarks on the manner of ad- 
ministering remedies in cases of great irritability of the stomach, re- 
marks, though seemingly of little importance every where else, may 
not be entirely so at the bed-side of the sick, I close what I have to 
say on the Washington yellow fever, the history of which disease, if 
it does nothing else, will show that an epidemic yellow fever is not 
necessarily confined to water-courses. 

I now proceed to give an account of some cases of malignant 
fever which originated at Haughton's tavern, in the country, about 
a mile from Natchez. Nine or ten persons died in and about this 
place with yellow fever. The disease commenced at Haughton's, 
in September, a little prior to its appearance in Natchez, " On the 
Hill." If medical topography throw light on the origin of yellow 
fever in other places, it does not withhold its light in the present in- 
stance. Haughton's tavern, and Shears's, (the two houses where all 
the cases referred to originated,) are situated without the chartered 
limits of the city, on a small peninsula formed by a junction of two 
very long, deep, and winding bayous. One of the bayous commences 
on the eastern, the other on the western, side of Natchez; and, with 
the exception of two or three squares, the whole of Natchez is drained 
by them. The western bayou, after draining the western part of 
Natchez, passes by the butcheries, receives their offal, and pur- 
sues a serpentine course, to meet its fellow, the eastern bayou, at 
Haughton's. 

Between the eastern bayou and the foot of the little hill, on which 
the houses alluded to stand, there is a flat surface of about an acre, 
surrounded on all sides by hills. A gully, leading through the 
isthmus formed by the two bayous, conducts the water of an adja- 
cent field on this flat surface, over which it spreads, before it falls 
into the bayou. Haughton's tavern is within ten steps of this flat 
ground, which, besides what the gully brings on it, and besides its 
own vegetable productions, is the receptacle of the kitchen offal, and 
of a privy which has no well. When the eastern and western bayous 
meet, a distance from the tavern of about thirty rods, there is also a 
flat surface surrounded by hills. The eastern and western bayous, 
in their whole course from Natchez, are seldom less than ten feet 
wide, and ten feet deep. In many places they are more than fifty 
yards wide, and as many feet deep. Their banks, which are steep 
and abrupt, are almost constantly falling in, which obstructs the 
current of water from a light rain, but affords no obstructions to the 
torrents which roll down them during heavy rains. In 1822, the 
yellow fever prevailed at this place. I then supposed that the pol- 
luted atmosphere of the city had extended thus far. I was inclined 
to this opinion, as several persons, whom I attended, assured me that 
they had not been in town. I did not, at that time, suspect the 



MALIGNANT FEVER. 393 

bayous of having any agency in the production of yellow fever ; but 
I have, since that time, in my practice through various parts of the 
adjacent country, which abounds with these bayous, found the re- 
mark verified, of an old practitioner of this place, the late Dr. Seip, 
that a "bayou was more sickly than a marsh." 

I again return to Natchez. The yellow fever " On the Hill," in 
1825, differed but little from that of Washington. But " Under the 
Hill," it resembled more closely , in its symptoms and progress, that 
of 1S23. Nearly all the physicians who got much practice, adopted 
the emetic plan of treating the disease of the present year, and these 
seldom lost more than one in ten of their patients ; while, under the 
old plan of trusting to a few grains of calomel, frequently repeated, 
with inunction of mercurial ointment in order to bring on salivation, 
the disease was about as fatal as formerly. Dr. Hunt, who came to 
Natchez very much prejudiced, by education, against emetics in 
yellow fever, but who is too liberal to advocate the errors of theory, 
unsupported by facts, threw aside his prejudices, and not only pre- 
scribed emetics with great success to his patients, but when attacked 
with yellow fever himself, commenced the cure by an active emetic: 
so did Dr. Walker. Neither of these gentlemen ever had cause to 
repent of this first, yet all-important, step in the treatment of their 
disease. 

Prevention. — As respects the best method of preventing the 
disease, while usual health exists; and the best method of preventing 
the disease, when those who are exposed to its cause become indis- 
posed, Dr. Cartwright makes the following observations: Those 
persons in health, who, in order to avoid an attack of this epidemic, 
had recourse to medicines and ardent spirits to which they were un- 
accustomed, were among the first to be attacked. Fumigations and 
the smelling of volatile substances, were also found to be of no ser- 
vice. Those persons who escaped, regulated their diet and drinks, 
not by any fixed rule or standard, but by their former habits; and if 
they deviated from those habits, they approximated to simplicity 
and abstemiousness, not carried to the extent of debility ; for if the 
stomach were not sufficiently excited by food and drinks, the same 
effect was produced as if it had been too highly stimulated; namely, 
a derangement of action between it and the organs with which it is 
associated. Those who had been temperate and abstemious, con- 
tinued -to be so.- Two persons who had, for several years, kept up 
a strong excitement by ardent spirits, continued it during the preva- 
lence of the epidemic, and entirely escaped. But all who had not 
previously been habitual drunkards that imitated their example, be- 
came sick and died. Ardent spirits kept up the equilibrium of action 
in the systems of the former, but destroyed the equilibrium in the 
latter. Finally, those who escaped were such as preserved this 
equilibrium, by accommodating their diet, drinks, sleep, and exercise, 
to the existing state of the system, and to their former habits, avoid- 
ing all exciting causes, as heat, cold, fatigue, &C. 
50 



394 MALIGNANT FEVER. 

As to those who are indisposed ', it was found that the best means 
of warding off the attack, or rendering it milder, was to ascertain in 
what way the threat is made, and to apply the remedies accordingly. 
Persons of plethoric habit, whenever they felt a fulness and uneasi- 
ness about the head, or a disposition to fever, were relieved by bleed- 
ing, and escaped. Others, whose indisposition proceeded from a 
torpid state of the bowels to which they were subject, escaped by the 
occasional use of aperients. To those who complained of a bitter 
or mawkish taste in the mouth, sickness at the stomach, achings in 
the bones, soreness of the flesh, and sleeplessness, emetics were pre- 
scribed with success. A gentleman who complained of pain in his 
back, with restlessness and anxiety, and whose urine had, for several 
days, been small in quantity, was enabled, by a free use of diluent 
drinks and diuretics, entirely to .avoid the attack of the epidemic. 

From these facts it is plain, that though the poisonous atmosphere 
of yellow fever may long be breathed with impunity, while a due 
balance of action among the various organs is preserved, yet not so 
when it is broken; that living in such an atmosphere tends to break 
this balance ; the smallest disturbance of which is announced by 
symptoms that often point directly to the organ in which the distur- 
bance has commenced, and which, in many cases, may, by timely 
and appropriate measures, be restored to its healthy functions. 



ADMONITORY 



HINTS TO LADIES 



Light were my task, if every gentle breast, 
Owned the just laws of native truth imprest; 
For not by hopes of vain applause misled, 
In reason's injured cause alone I plead. 
'Tis you to judge; nor I that judgment fear 
If truth be sacred, and if virtue dear. — Roscoe. 

If we consider but for a moment the wonderful power which 
superior beauty in woman exerts over the human breast ; how in- 
stantly, on the approach of its possessor, the hearts of the young are 
thrown into the most delightful palpitations, and the looks of the 
aged brightened with admiration and pleasure ; we can no longer 
wonder that it should be so highly prized by the sex. But it is to 
be lamented, that the most preposterous means should be employed 
to gain a property so desirable, and that real beauty should be so 
often abused. 

Thus, some girls fancy that beauty can onty exist in forms slen- 
der and delicate. At the very thought of being corpulent, they are 
alarmed, and to obviate grossness, as they call it, they drink such 
quantities of vinegar, that it not only destroys the tone of the sto- 
mach, but introduces a withered ghastly paleness. We knew a lady 
whose practice was to devour many pickles every day for the pur- 
pose (as she thought) of preventing obesity. The consequence was 
that she lost the healthy tone of the stomach to such a degree that 
at last she could retain scarcely any article of food. She wasted 
away to a shadow, and life itself became a burden. For the same 
purpose they continue the absurd practice of wearing jackets, or cor- 
sets, so oppressive, as, by compressing the ribs, to prevent the expan- 
sion of the lungs. 

Another imprudence, and still more detrimental, is that of appear- 
ing at assemblies, in winter, in light dresses, exposed to the baneful 
effects of cold, with the aggravating addition of extraordinary warmth, 



396 ADMONITORY HINTS TO LADIES. 

by the fatigue of dancing; hence, consumptions, and a train of 
maladies, too long to be here particularly described, are produced. 

Motives of delicacy, as well as regard for health, have been re- 
peatedly urged in vain to enforce the necessity of relinquishing these 
destructive habits ; the arguments of the moralist and of the physician, 
having alike failed to convey conviction ; and hundreds, who would 
now have been shining forth among the loveliest of their sex, are 
dressed in shrouds, because, "in an evil hour," they laid aside those 
articles of their apparel which health, as well as decency, forbade 
them to relinquish. 

There are others, who, reading of the fair-skinned belles of Europe, 
foolishly conclude that the rose and the lilly are the only colors of 
beauty. 

Catching at this female passion for fair and unfreckled faces, the 
quacks have prepared a number of nostrums, called cosmetics or 
beautifiers, which, they vauntingly profess, are to heal the chaps on 
the lips ; to remove pimples and freckles ; and to give the counte- 
nance such a fair, smooth and charming appearance, as to render it 
impossible for any one to contemplate it without being enamoured. 
But, unfortunately, these boasted cosmetics, instead of heightening 
the polish and charm of beauty, too often contribute to tarnish and 
destroy them.* A fine lady of one of our large cities, one day after 
the use of one of these deleterious cosmetics had occasion to pass 
through one of the back streets on a damp, muggy day. On her 
return, she was amazed at the appearance of her skin, for since 
breakfast, she had turned quite black. A new compound had been 
formed by contact with a nauseous gas emanating from the portion 
of the city she had visited. 

Beauty ceases to be attractive when we know it to be artificial. 
Far from admiring, we turn away with disgust. We recently had 
occasion to admire the beautiful rose and lily of a handsome woman. 
It was of an evening. Calling the next morning on a professional 
visit to another branch of the family, and catching a glimpse of my 
fair lady, we shall never forget the sensation of disgust at the change 
in her complexion. A face naturally fair and of a sweet expression, 
had been awfully marred by the application of these poisonous 
cosmetics. 

The truth is, beauty is not the creature of a quack, but the gift of 
nature ; and to bring it to perfection, nothing more is necessary than 
exercise, cleanliness, temperance, and cheerfulness. These are the 
handmaids of health ; and health, to persons of certain symmetry 
and expression, is beauty. 

* To such of my readers as are partial to the use of cosmetics, an infusion 
of horse-radish in milk is recommended as one of the best and safest. Another 
innocent preparation for clearing the skin of pimples, and recent eruptions, is 
the expressed juice of house-leek, mixed with an equal quantity of sweet milk 
or cream. When these fail, blistering the face all over the eruptions will 
often succeed in removing them. 



ADMONITORY HINTS TO YOUNG LADIES. 397 

The rural wilds 



Invite ; the mountains call you, and the vales, 

The woods, the streams, and each ambrosial breeze 

That fans the ever undulating sky ; 

A kindly sky ! whose fostering power regales 

Man, beast, and all the vegetable reign. — Armstrong. 

How much, then, is it to be deplored, that so many of our young 
females should think so meanly of exercise, which, alone, brings the 
female frame to perfection, paints it in the liveliest colours, and, by 
giving richness to the blood, and vigour to the nerves, disposes to 
habitual cheerfulness, and alike qualifies the mind for thought, and 
the heart for love. 

On the contrary, how different is the female who leads an inac- 
tive and sedentary life, too generally looked on as proofs of a fine 
modern lady, which seldom fails to relax the system, retard the cir- 
culation, vitiate the blood, and obstruct the secretions. Hence that 
chalky paleness of the face — that faintness of the eyes, indigestion, 
flatulence, weak nerves, low spirits, irregularities of nature, and con- 
stant complainings. 

The grand discharge, th 5 effusion of the skin 

Slowly impaired, the languid maladies 

Creep on, and through the sinking functions steal. 

Armstrong. 

Yes, many a girl by constant muffling and housing herself ; by 
dreading that the sun should ever kiss her cheeks, or the wind ruffle 
her tuckers ; by much indulgence in bed, and other imprudences, 
renders herself so exceedingly pale, delicate, and puny, that her ap- 
pearance is better fitted to damp love than to excite it. 

"The vigour sinks, the habit melts away; 
The cheerful, pure, and animated bloom 
Dies from the face, with squalid atrophy 
Devoured." 



MANAGEMENT 



OF 



FEMALE COMPLAINTS 



MENSTRUATION. 

One of the principal constitutional characteristics of the female, is 
menstruation, or the monthly evacuations peculiar to the sex. 

This important operation generally takes place about the age of 
twelve or thirteen ; but varies through the world, either in degree or 
frequency, both from constitution and climate. 

Women in the higher ranks of life, and those of a delicate nervous 
constitution, are subject to sickness, headache, and pains in the back 
and loins, during the periodical evacuation. Those of the lower 
rank, inured to exercise and labour, and strangers to those refine- 
ments which debilitate the system, and interrupt the functions essen- 
tial to the preservation of health, are seldom observed to suffer at 
these times, unless from general indisposition, or a diseased state of 
the womb. 

After the discharge has become established, it recurs periodically 
while in health ; and its recurrence is so regular that it can be cal- 
culated with great exactness. The usual period of its visitations is 
from twenty-seven to thirty days. As to the time of its continuance, 
this is various in different women ; but it seldom continues longer 
than six days, or less than three, and does not cease suddenly, but in 
a gradual manner. 

Its approach is generally preceded by certain feelings of oppres- 
sion or deviation from the ordinary state of health, which warn the 
individual of what is to happen. There is, in particular, a sensation 
of fulness about the lower part of the belly, and a relaxation about 
the uterine system, which can scarcely be overlooked by the most 
heedless. It must at the same time be admitted, that in some few 
constitutions these feelings are so inconsiderable as to be little at- 
tended to ; so that the woman mixes in society as usual, without any 
apparent inconvenience. 



MANAGEMENT OF FEMALE COMPLAINTS. 399 

It is of importance for women to know that occasional irregulari- 
ties are not always the consequence of disease. Constitutions vary- 
as much in respect to the regular returns of this discharge, as they 
do with regard to its first appearance or its final cessation. Those 
in whom the change occurs very early from vigour of constitution, 
require little to be done for them ; but, in weak and delicate habits, 
the non-appearance of this evacuation is too often considered as the 
cause, whereas, it ought to be viewed as the effect, of the state of the 
habit unpropitious to its taking place. And, according to family 
practice, under this false impression, warm teas and forcing medi- 
cines are employed at the approach of this disease, which have often 
done much harm. 

Nature is not so defective in her own judgment as to require such 
auxiliaries. Care should be taken to improve the general state of 
their health, by attention to diet, moderate exercise, change of air, 
and cheerfulness ; which will be found to have the happiest influ- 
ence on the body and mind, and gives a salutary impulse to the 
circulation of the blood. With respect to the flow of the menses, 
women should remember, that what is to one woman a due propor- 
tion, wouid be to another, from the difference of constitution, and 
temperament, an immoderate flow ; and before they attempt to re- 
strain it, let them carefully consider, what may have been the exci- 
ting or occasional cause. They are too frequently told that such a 
situation arises from mere debility ; and under that belief will take 
cordials, and stimulating medicines. In general, this is not the case : 
and by such improper treatment, the flow is increased, and the habit 
rendered feverish. 

The quantity generally discharged in a healthy and regular 
woman, is from four to six ounces at each visitation. Those of a 
delicate constitution have, however, a more copious and longer con- 
tinued discharge than persons of a robust habit; thus, the full 
blooming country girl does not discharge half the quantity that the 
pale-faced lady of quality does. In some instances, the menstrual 
discharge does not make its appearance before the age of seventeen 
or eighteen, and, nevertheless, health is not in the least affected. 
The mere want of evacuation at the ordinary time, therefore, is not 
to be considered as morbid, unless the system be evidently deranged 
thereby. In many cases, however, symptoms of disease appear 
which are evidently connected with the defect of the menses, and 
go off upon its discharge. The treatment, in such cases, must be 
regulated by the particular circumstances and constitution of the in- 
dividual. There is no remedy adapted to every case of this kind ; 
byt an open state of the bowels, and a due regulation of the diet, to- 
gether Avith moderate exercise, are useful in every instance of this 
complaint. Warm clothing, too, particularly about the lower ex- 
tremities, is of most essential benefit. The occasional use o( the 
warm bath is pleasant and beneficial, especially if the skin be dry 
and warm. As the health improves, the cold bath will prove an 



400 MANAGEMENT OF FEMALE COMPLAINTS. 

auxiliary, if, after using it, the patient feels a glow of heat, and a 
greater degree of liveliness. When the means ordinarily employed 
have failed, marriage, or a change of climate, has produced the 
wished-for effect. 

In some instances the evacuation is impeded by a mechanical 
cause, that is, an obstruction of the passage to the womb. This oc- 
casionally is met with, and the chief obstacle to its speedy removal 
is the difficulty of ascertaining its existence. The operation by 
which it is completely remedied, is not more painful nor formidable 
than blood-letting. 

Fortunately, in most cases, the evacuation takes place in due time, 
and the constitution sustains no material or permanent injury. It 
is, however, in every instance, proper to pay particular attention to 
the system during the continuance of the evacuation. 

The stomach and bowels, at this period, are very easily disordered, 
and, therefore, every thing which is heavy or indigestible, ought to 
be avoided. Some are hurt by eating fruit or vegetables; others by 
taking fermented liquor. In this respect experience must enable 
each individual to judge for herself. Exposure to cold, particularly 
getting the feet wet, is hurtful, as it tends suddenly to obstruct the 
discharge. The same effect is likewise produced by violent passions 
of the mind, which are also, at this time, peculiarly apt to excite 
spasmodic affections, or hysterical fits. 

It is, in general, a very proper rule not to administer any very 
active medicines, at this time, unless some violent symptom abso- 
lutely requires them. Opiates, for instance, are, in many cases, 
necessary to allay spasmodic affections, or abate pain; and they are, 
in such circumstances, uniformly safe. They give speedy relief to 
hysterical feeling or suffocation, or to spasms of the stomach and 
bowels. Blood-letting is also, in some instances, necessary, from 
particular circumstances, at this period, and in such cases it is safe, 
and does not obstruct the evacuation. 

Dancing, exposure to much heat, or making any great or fatiguing 
exertion, are improper. These causes may increase, to an improper 
degree, the quantity of the evacuation, and in certain circumstances 
may give a disposition to a falling down of the womb. 

To conclude, the period or time of life, when the monthly eva- 
cuation should disappear altogether, is considered as critical. It is 
really so in two cases. The first is, when the woman has suffered 
considerably at each period, from sickness, pain, and disorder of the 
bowels. Such women, not unfrequently, when the constitution is 
freed from the monthly change, enjoy better health than formerly. 
The second is, when there is a tendency to disease, in some particu- 
lar organ, especially in the womb itself, in some of the abdominal 
viscera, or in either of the breasts. In such cases, the time of life 
may prove the period, at which the disease begins to make its 
progress. 

The time at which this evacuation ceases, varies from the forty- 



MANAGEMENT OF FEMALE COMPLAINTS. 401 

fourth to the fiftieth year. It is usual, for some time before it dis- 
appears, that it should become irregular. It not only is sometimes 
greatly less, and again much more in quantity than usual ; but it is 
also occasionally obstructed for some months ; and then, perhaps, 
comes oftener than it ought to do. The occasional obstruction, be- 
fore the final cessation of the discharge, is frequently accompanied 
with sickness and swelling of the belly, from the wind in the bowels. 
These circumstances, sometimes incline married women, for some 
weeks, to consider themselves with child. 

Others again, averse to be thought old, flatter themselves that the 
irregularity is occasioned by cold, or some accidental circumstances, 
and therefore very improperly employ their utmost endeavours to 
recall it. 

The complaints which, in many women, occur at this period of 
life, are to be ascribed rather to a general change in the habit, than 
merely to the absence or total cessation of the sexual evacuation. 

Women who have never had children, or good regular health, or 
those who have been weakened by frequent miscarriage, are most 
apt to suffer at the decline of life. 

It frequently happens, that women who were formerly much 
pained when out of order, or who were troubled with nervous and 
hysteric complaints, begin at the cessation of the periodical discharge 
to enjoy a good state of health, to which they had formerly been 
strangers. 

When no particular complaint occurs in consequence of the de- 
cline of life, it would be exceedingly absurd to reduce the strength 
by an abstemious diet and low living. 

If, on the contrary, headache, flushings of the face, or an increased 
degree of heat, restlessness in the night, and violent pains in the 
belly and loins, swellings of the feet, or eruptions on different parts 
of the body, take place at this period, there is reason to believe that 
a general fulness exists, in consequence of the stoppage of the ac- 
customed discharge. Under such circumstances, spare living with 
increased exercise, occasional blood-letting, and frequent gentle pur- 
gatives are enjoined. 

If ulcers break out in the legs, or in any other part of the body, 
on a total cessation of the menses, they ought to be regarded as criti- 
cal discharges, and should by no means be healed up without, sub- 
stituting some other drains by an issue. 



PAINFUL MENSTRUATION. 

In some instances, menstruation is attended with great pain in the 
back, thighs, and lower part of the belly. This state is sometimes 



402 MANAGEMENT OF FEMALE COMPLAINTS. 

accompanied with suppression of urine, or violent colic pain and 
spasms of the stomach. The discharge generally takes place slowly, 
and is deficient in quantity, and not unfrequently attended with the 
expulsion of a skinny looking substance. 

Causes. — This disease is supposed to be owing to a weak action 
of the vessels of the uterus, or spasm of the extreme vessels. Pain 
sometimes attends copious menstruation ; but whenever it does, 
there is much reason to apprehend some local disorder of the womb. 

Treatment. — As soon as the symptoms that denote its approach 
are apparent, recourse should be had to the warm bath ; when this 
is not convenient, the patient should sit fifteen or twenty minutes in 
a tub of warm water, or cloths wrung out of warm water, or a bladder 
two-thirds filled with it, should be applied to the low T er part of the 
belly. After this the back and abdomen should be well rubbed 
with the camphorated, or volatile anodyne liniment, and if the pain 
continue, the anodyne clysters should be administered. If, notwith- 
standing these means, the pain become violent, it will be proper to 
give a tea-spoonful of the diaphoretic drops, or four or five grains of 
Dover's powders, or one of the camphorated powders, (see Dispen- 
satory,) every hour or two until a gentle, but general perspiration 
be induced. This is also to be encouraged by drinking warm penny- 
royal or ginger tea. When this complaint arises from general ful- 
ness and irritation, it may require repeated bleeding and purging. 
If there be pain in the stomach without fever, give a tea-spoonful 
of laudanum, with twenty drops of essence of peppermint; or should 
costiveness prevail, give a dose of castor oil in conjunction with the 
anodyne. 

For the cure of this distressing complaint, Dr. Fothergill recom- 
mends a pill of opium, of one grain, to be taken the moment the 
pain comes on, and to be repeated every hour until it be suppressed ; 
to keep the patient in bed ; and to let her dilute freely with herb 
teas, until the discharge be fully established, after which the pain 
seldom returns ; and when the period has passed, chalybeate bitters 
until within a few days of the next period. Dr. Denman proposed 
small doses of calomel every night at bed-time, for several weeks to- 
gether, and twice in the course of the day, a dose of the volatile 
tincture of the Peruvian bark. Dr. Dewees, of Philadelphia, re- 
commends the volatile tincture of gum guaiacum, to be continued 
for a considerable length of time, and says it acts almost as a specific. 
And Dr. Robertson, of Edinburgh, is as sanguine in praise of the 
tincture of cantharides given in pretty large doses, thrice a day, until 
it excites some degree of pain in voiding the urine. 

Preventiox. — In order to prevent this painful state, in those who 
are subject to it, the warm bath should be used, three or four nights 
preceding the menstrual period, and on going to bed, two tea-spoons 
full of the diaphoretic drops, or ten grains of Dover's powder should 
be given in some warm tea. The bowels are to be kept uniformly 



MANAGEMENT OF FEMALE COMPLAINTS. 403 

regular ; and exposure to cold, especially near the time of the ap- 
pearance of the discharge, is to be carefully avoided. 

The constitution is to be improved, and strengthened by such 
means, as its particular condition requires ; and in general, by the 
use of tonic medicines, and the shower bath, provided these do not 
disagree with the patient. 



OBSTRUCTED MENSES. 

Many women have the menstrual evacuation postponed for a week 
or two, beyond the usual time, or miss one or two periods without 
any very evident cause, and without inconvenience. But when it 
is suddenly suppressed very troublesome symptoms occur ; and when 
it is retained for any considerable length of time, it is generally ac- 
companied by bad health. 

Symptoms. — When suddenly checked, it is usually attended with 
considerable pain in the back, bowels, or stomach, and sometimes in 
the chest. In persons of a full habit the face is generally flushed, 
the pulse hard and frequent, flying pains in the chest, perhaps, spit- 
ting of blood, cough, palpitation, difficulty of breathing, and a com- 
plication of nervous affection. 

Persons of a delicate frame and a melancholic temperament, and 
especially those who have suffered from some debilitating cause, 
have different symptoms, constituting what has been called chlorosis, 
or green sickness, a disease always connected with, and depending 
on, some derangement of the sexual organs. 

In chlorosis, every symptom of feebleness prevails, a pale skin, 
and even a greenish complexion, succeeds to the rosy hue of health; 
the skin under the eyes puffy and of a leaden colour ; the whole body 
lax, cedematous and doughy ; the judgment, memory, and natural 
cheerfulness impaired ; the pulse is generally slow and feeble, but 
easily excited ; and it is then accompanied with shortness of breath, 
a palpitation of the heart, and an almost unconquerable disinclina- 
tion to motion ; the appetite is destroyed, and the stomach so de- 
ranged, that the food, instead of being digested, undergoes the fo- 
mentation peculiar to its nature. Hence, the patient rinds gratifica- 
tion in chalk, lime, pieces of old wall, and other improper sub- 
stances ; and the bowels are commonly costive. 

It not unfrequently happens that the blood which should have 
passed off by the uterus, being determined more copiously and for- 
cibly to other parts, gives rise to hemorrhages; hence, it is fre- 
quently poured from the nose, stomach, lungs, and other parts, in 
such cases. 

When women (says Denman) are deprived of the common ute- 
rine discharge, they are sometimes liable to periodical emissions of 



404 MANAGEMENT OF FEMALE COMPLAINTS. 

blood from the nose, lungs, ears, eyes, breasts, navel, and almost 
every other part of the body. 

To constitute the menses it is not necessary that the discharge 
should take place from the uterine or even genital organs, for some 
women have them by other passages, manifested by periodical vomit- 
ing, coughing of blood from the lungs, bleeding from the hemorr- 
hoidal veins, nose, and so on. — Edinburgh Medical and Surgical 
Journal. 

Causes. — A constriction of the extremities of the vessels of the 
womb, arising from accidental circumstances, such as exposure to 
cold, anxiety of the mind, fear, excessive evacuations, inactivity of 
the body, poor blood, the frequent use of acids, and other sedatives, 
&c. In some constitutions, particularly in those where pain attends 
the discharge, very slight occurrences suddenly interrupt the flow, 
and prevent its usual return, such as passions of the mind, fright, fa- 
tigue, irregularities of diet, putting on damp clothes, &c. This fact 
shows the necessity for certain cautions and attention during the dis- 
charge. Obstructions, too, are sometimes the effect of disease of the 
general habit. 

Treatment.— When the evacuation has been suddenly checked, 
it is proper to have immediate recourse to the warm bath, or sitting 
up to the hips in warm water, or fomentations to the lower part of 
the abdomen, and bathing the feet in warm water. It is also advis- 
able to put the patient to bed and give a tea-spoonful of the diapho- 
retic drops, or five or six grains of Dover's powders, in a cup of 
warm herb tea, such as sage, hyssop, penny-royal, every two hours, 
until a gentle perspiration is produced. Should there be fever, or 
pain in the head, or discharge of blood from other organs, bleed, 
give the cathartic mixture, or an infusion of salts, senna and manna, 
and afterwards endeavour to determine to the surface by the exhibi- 
tion of diaphoretic medicines. In every case where there are febrile 
symptoms, an amendment cannot take place until the antiphlogistic 
plan, such as bleeding, nitrous medicines, cooling cathartics, and a 
low diet, with rest, are adopted. After the febrile symptoms are 
removed, strengthening medicines, if necessary, may be employed, 
and in no instance suffer the bowels to remain in a constipated state. 

It is necessary to observe, in endeavouring to restore the monthly 
evacuation, we shall more likely succeed, if the usual remedies for 
removing the constriction which affects the extremities of the vessels 
in the womb are directed at the time of its expected return, or when 
some natural efforts for that purpose are observable ; which may be 
known by a sense of fulness in the organs of generation, a weight 
in the back and loins, and slight spasmodic pains in the uterus. At 
this period, bladders two-thirds filled with warm water, applied to 
the lower part of the abdomen, or sitting over a vessel filled with 
hot water, will have a most happy effect. And, to increase the re- 
laxing powers of these topical applications, we may, at the same 



MANAGEMENT OP FEMALE COMPLAINTS. 405 

time, give an opiate, particularly in the form of clyster, when there 
is pain. 

Sometimes an emetic administered about the time when the 
evacution should appear, and the patient during- the operation to sit 
in a warm bath, has been of infinite service. In some instances an 
obstruction may continue in a young and healthy woman, for many 
months, without any inconvenience. This is chiefly the case in 
those who are very corpulent, or who have been in the pernicious 
practice of employing vinegar and strong purges to reduce their size. 
By the regular use of exercise, rising early in the morning, avoiding 
supper, keeping the bowels correct, and living, upon the whole, 
rather abstemiously, the health will be preserved, and, in course of 
time, the desired alteration will take place. 

Obstruction of the menses may also occur in young women with 
florid complexions, but, at the same time, of very delicate constitu- 
tions, and subject to a slight cough, with pain in the breast, and a 
predisposition to consumption. Such cases require the utmost cau- 
tion; and in them, small bleedings, an antiphlogistic diet, mild laxa- 
tives, a temperate climate, warm dress, and moderate exercise, are 
essential: and when it can be procured, a sea-voyage, or change of 
air, will probably prove the most useful remedy- 
In the chlorotic species of obstruction, the treatment is much the 
same, as advised under the head of menstruation, for the manage- 
ment of those who are long having this evacuation. It will be found, 
almost in every instance, the complaint is occasioned by general de- 
bility, consequently, the cure must be regulated on the plan of in- 
creasing the tone of the system and exciting the action of the uterine 
vessels in particular. This is to be effected by a nourishing diet, 
moderate use of wine, change of air, gentle exercise, particularly 
riding on horseback, with strengthening medicines, as bark and elixir 
vitriol, the rust or tincture of steel, or the tonic powders or pills in 
their usual doses, together with the occasional use of calomel or the 
stimulating purgative pills, (see Dispensatory ,) to keep the bowels 
in a regular state. The nitric acid, diluted in doses of a wine glass 
full three or four times a-day, will be found a valuable medicine to 
improve the habit of body. And if the obstruction be attended with 
cough, it should be given in the form of the nitric lac-ammoniac 
(See Dispensatory.) 

Previously to the use of tonic medicines, it is advisable to give an 
emetic, and afterwards a dose of calomel and rhubarb, or the aperient 
and diaphoretic pills, for the purpose of cleansing the stomach and 
freeing it from acidities and inactive fluids. Costiveness being a 
constant attendant on this disease, it is of the greatest importance, 
that purgatives be repeated, until all the sordes which have been 
collecting, most probably, for a considerable length of time, shall be 
removed. After this, and not before, the happiest effects may be ex- 
pected from the use of tonic medicines. 

Besides the above remedies, many others may be employed with 



406 MANAGEMENT OF FEMALE COMPLAINTS. 

the same view, as an infusion of camomile, wild cherry, or dog- 
wood bark, tansy, penny-royal, hyssop, rue, &c. A table- spoonful 
of mustard seed, morning and evening, or a tea cup full of a weak 
infusion of horse-radish, on some occasions have produced very good 
effects. 

Two ounces of the rust of steel, or filings of iron, steeped in a bottle 
of wine or cider for a week, and given in doses of a small wine- 
glassful, morning, noon, and night, has also been found beneficial. 

With the view of exciting into action the uterine vessels, the sur- 
face of the body should be kept warm by means of a flannel shift 
and drawers, by frequent friction of the lower part of the abdomen 
and limbs with a flesh brush or flannel, and by the exercise of walk- 
ing, dancing, and jumping. By marriage, or a change in the mode 
of life, the disorder has frequently been removed, after having resisted 
all the ordinary remedies. 

In those instances where the evacuation has become suppressed 
in consequence of previous bad health, it is evident that no attempt 
to restore it can either be effectual or useful till the cause be re- 
moved. Some have obstruction caused by very slight weakness, or 
very early in chronic diseases, others continue regular, till even the 
last stage of consumption. From the great variety of causes of sex- 
ual obstruction, it is certain that many medicines, which possess very 
opposite powers, may, in different cases, produce the same effects. 
For the same reason, a remedy which, in one case, may prove mild, 
inoffensive, and successful, will, in another apparently similar, occa- 
sion a most violent disorder. No remedy applicable to every case 
can possibly be discovered, therefore, medicines, with a view to re- 
store the periodical evacuation, ought to be employed with the 
greatest caution. 



IMMODERATE FLOW OF THE MENSES. 

This alarming complaint may occur under two different states of 
the constitution. In the one, the woman is of a full habit, and often 
of a ruddy countenance. In the other, she is pale, delicate, and 
easily fatigued. 

Symptoms. — In plethoric habits it is often preceded by headache, 
giddiness, or difficult breathing, and is afterwards attended with pain 
in the back and loins, universal heat, and a frequent, strong, and 
hard pulse. But, when it arises from general debility, or in conse- 
quence of a laxity of the organ, paleness of the face, chilliness, las- 
situde of the whole body, oppressed breathing on the slightest effort, 
pains in the back on remaining any length of time in an erect pos- 



MANAGEMENT OP FEMALE COMPLAINTS. 407 

ture, and coldness of the extremities, together with a long train of 
nervous complaints. 

Causes. — A variety of causes may produce this troublesome dis- 
ease. Some of these are general, such as a state of great weakness, 
or of too much blood ; others are local, such as debility of the ute- 
rus, occasioned by tedious labour or frequent miscarriages. It may 
also be produced by accidental circumstances determining the blood 
more copiously and forcibly into the uterine vessels, as violent exer- 
cise in dancing, much straining at stool from great costiveness, con- 
tusion on the belly, excess in venery, or strong passions of the mind, 
particularly at the menstrual period. 

Treatment. — In the management of this disease we have two 
objects : first, to moderate the discharge and procure present secu- 
rity ; and, secondly, to prevent a return. 

The first thing to be done when the hemorrhage is sudden or pro- 
fuse, is instantly to remove the clothing which may occasion the 
least interruption to the free circulation of the blood, and to put the 
patient to bed, lightly covered with clothes. So long as the dis- 
charge continues, it is of importance to keep her in a recumbent 
posture, as cool as possible, and perfectly at rest, both in body and 
mind. Cloths, dipped in cold vinegar and water, and renewed as 
often as they become warm. These cold applications have a pow- 
erful effect in restraining uterine hemorrhage, and ought never to be 
omitted where the discharge of blood is profuse. 

If the patient be of a full habit, attended with severe pain in the 
head or back, and febrile symptoms, it will be proper to bleed, and 
to give the antimonial, or febrifuge powders or mixture. (See Dis- 
pensatory.) 

The state of the belly must also be attended to. It can be kept 
gently open by the cathartic mixture, sulphur, or any mild laxative 
medicine. Stimulating purgatives, or clysters, under such circum- 
stances, are improper, from their tendency to increase the discharge. 

When no symptoms indicating an increased action in the vessels 
of the womb are present, astringent medicines should be employed. 
And, in cases where the discharges have not continued long, and the 
strength not much impaired, it is often sufficient to arrest the disease 
by giving fifteen or twenty drops of elixir vitriol, or six or eight grains 
of alum dissolved in a glass of cold water every hour ; or, what is 
preferable, alum whey, sweetened to the taste, in doses of a small 
cup full, as often as the stomach will receive it. But, if the dis- 
charge be obstinate, we should have recourse to pills of sugar of lead 
and opium. (See Dispensatory.) 

In no instance which has come under my knowledge, where the 
hemorrhage was in consequence of a laxity of the uterine vessels, 
have these pills failed in producing the desired effect 

In those cases where the hemorrhage is profuse, or o( long con- 
tinuance, and resists the means already pointed out, it will bo proper 
to inject into the uterus from a gill to half a pint o( a strong decoo 



408 MANAGEMENT OF FEMALE COMPLAINTS. 

tion of oak bark, in which one or two drachms of alum have been 
dissolved, or as much of the saturated solution of alum in water, in 
order to constringe and strengthen the vessels of the womb. This 
may be repeated twice or thrice a-day, according to circumstances. 

When symptoms of an increased action in the vessels of the womb 
are observable, the tincture of foxglove, in doses of twenty drops 
every four hours, constitutes the best remedy. 

When there is reason to suppose the hemorrhage proceeds from a 
scirrhous or ulcerated state of the womb, all that can be done, is to 
afford temporary relief by giving opium in large doses. Indeed, 
opiates may be given with advantage in every case where there is 
considerable pain or anxiety, and the patient much exhausted. 
Under these circumstances, from one to two tea-spoons full of lauda- 
num, or from two to four grains of opium, according to the urgency 
of the case, will be useful not only in giving a check to the dis- 
charge, but also in preserving the strength, and abating nervous irri- 
tation. In most cases it is preferable to give opium in the form of 
injections to allay the spasmodic pains of the womb ; and, when 
administered in this way, clysters of thin starch or gruel, in each of 
which two tea-spoons full of laudanum are added, should be given 
every two hours until relief be obtained. (See Abortion and Flood- 
ing.) 

In a female greatly reduced in strength and much emaciated, with 
an excessive menstrual flow, Dr. Dewees gave half a tea-spoon full 
of laudanum and the same quantity of Hoffman's anodyne liquor, 
and two grains of sugar of lead with one-third of a grain of opium, 
every hour till the discharge should be moderated. These remedies 
proved of great service, but early next morning, the flow Avas much 
increased. He now ordered twenty grains of sugar of lead, a tea- 
spoonful of laudanum and a gill of lukewarm water, as an injection. 
This quickly arrested the discharge, which did not return. Exer- 
cise and sea-bathing soon confirmed her health. 

Regimen. — The diet, at the time of excessive discharge, must be 
light and cool. The drink must always be cold, as ice-water, lemo- 
nade, or tamarind beverage. Port wine, in such cases, is too fre- 
quently resorted to, which uniformly does harm by increasing the 
circulation. 

Prevention — To prevent a recurrence of the attack in those 
who are subject to it, the patient must necessarily avoid the causes 
by which it has been produced. 

When it is evident that the discharge is in consequence of a full 
habit, it will be proper to reduce the system by living sparingly, by 
keeping the bowels rather in a laxative state, and by rising early, 
and taking through the day regular but frequent exercise ; and, after 
the plethora is removed, by strengthening the vessels, which have 
been over-distended, by the use of the cold bath. 

In a greater number of cases, however, we meet with a delicate 
constitution and spare habit, with pale countenance : this state re- 



MANAGEMENT OF FEMALE COMPLAINTS. 409 

quires the use of sea bathing or the shower bath, and the vessels of 
the womb are particularly strengthened by pouring cold water daily 
on the back and loins. 

It will be advisable to use a generous nutritive diet, with wine, 
and to have recourse to some of the tonic medicines, as advised un- 
der the head of obstructed menses, to strengthen the system gene- 
rally. At the same time the bowels must be attended to, and invi- 
gorating exercise taken daily; whilst, on the other hand, fatigue, 
and especially exposure to relaxing heat, must be carefully avoided, 



SEXUAL WEAKNESS. 

This complaint, commonly called Jluor albus, or whites, to which 
women are peculiarly subject, must form an important object of 
attention, since it is always attended with disagreeable symptoms; 
and, when aggravated, soon spoils the beauty of a fine face, weak- 
ens the digestive powers, produces a general bad habit, and occasions 
sterility. 

Symptoms. — An irregular discharge from the passage leading to 
the womb, of a fluid, which, in different women, varies much in 
colour, being of a white, green, yellow, or brown hue. In the be- 
ginning it is, however, most usually white and pellucid, and, in pro- 
gress of the complaint, acquires the various discolorations and diffe- 
rent degrees of acrimony, whence proceed a slight smarting in making 
water. Besides the discharge, the patient is frequently afflicted with 
severe and constant pains in the back and loins, indigestion, pale- 
ness of the face, chilliness, and languor. In process of time, every 
symptom becomes highly aggravated, the feet and ankles swell, pal- 
pitations, and a difficulty of respiration are experienced, the men- 
strual discharge is rendered irregular, the urine is turbid, the mind is 
dejected, and either consumption or dropsy supervenes and termi 
nates a miserable existence. 

In some languid habits, the fluor albus returns periodically, instead 
of the proper menstrual evacuation, until the patient's constitution is 
duly invigorated. 

Causes. — It may be produced by any cause which either weak- 
ens or irritates the womb and its appendages. It may arise from 
general debility of the constitution, but it is especially caused by cir- 
cumstances impairing the power of the womb itself, as, for instance, 
a severe labour, a miscarriage, or profuse menstruation. 

In some instances it appears to depend on a full and irritable habit 
of body, and, in other cases, of local irritation, such as disorders oi 
the womb, or of the urinary organs, or a collection in the gut, of the 
small thready worms called ascarides. 
52 



410 MANAGEMENT OF FEMALE COMPLAINTS. 

Upon the high authority of Dr. Hamilton, this disease is most fre- 
quently first brought on by some imprudence in respect to diet and 
clothing, or exposure to cold or fatigue, or neglect of the bowels about 
the time when menstruation begins. 

Treatment. — In the treatment of this complaint regard must be 
had to the apparent cause, and to the state of the patient. The 
discharge is too often considered by the sex as the effects of general 
weakness in their habit, and, therefore, are led to the indiscriminate 
use of heating medicines, as port wine, balsam copaivi, &c, without 
paying attention to the habit of the body, or cause of the disease. 

A milk diet, change of air, and the partial cold bath, as sponging 
the loins and thighs with cold water every morning, with attention 
to cleanliness and proper exercise, are often sufficient to arrest the 
disease, if early adopted. 

In addition to this plan of treatment, if the patient be of a full 
habit, a disposition to fever from slight causes, attended with a sense 
of heat about the passage to the womb, it will be necessary to have 
recourse to the lancet, cooling cathartics, and febrifuge medicines, 
and to inject, several times a-day, flax-seed tea or milk and water, 
into the passage of the womb. In the great majority of cases, the 
complaint arises from general debility or laxity of the vessels of the 
parts, and in such cases the indications of cure are to increase the 
vital heat, promote the digestion, and restrain the preternatural dis- 
charge. In order to which, recourse must be had to such of the 
tonic medicines as will be found to agree best with the patient. Of 
these, the bark and elixir vitriol, the tonic powders or pills, the rust 
or tincture of steel, and lime-water have usually been employed, 
and often with good effects. In some instances, however, I have 
known these medicines to fail, when the nitric acid, diluted, (see 
Dispensatory ,) in doses of a wine-glassful, three or four times a-day, 
wonderfully succeeded. 

Previously to the exhibition of tonic medicines, it is advisable to 
give a dose of ipecacuanha or antimonial wine. Gentle emetics are 
supposed to be of singular utility in this complaint, not only by 
cleaning the stomach and bowels, and making a revulsion of the 
humours from the inferior part of the body, but likewise by their 
exciting all the powers of the constitution to a more vigorous action. 

The bowels must be kept in a regular state by conjoining a few 
grains of rhubarb with some of the tonic medicines, or by taking 
occasionally, at bed-time, one of the aloetic, or aperient or diaphoretic 
pills ; or, in the morning, a tea-spoonful of Epsom salts dissolved in 
a tumbler of water. 

If there be a fulness of the stomach after eating, the tincture of 
rhubarb in small doses will excite digestion. In obstinate cases, it 
is often expedient to produce a change in the system, by giving a 
grain or two of calomel, or one of the mercurial pills at bed- time, 
until the gums become slightly affected, and then the cure may be 
completed by strengthening medicines, together with the shower bath. 



MANAGEMENT OF FEMALE COMPLAINTS. 411 

Besides tonics, stimulating medicines, such as commonly deter- 
mine to the urinary passages, have very frequently been employed 
with great benefit. Of these, rosin in doses of ten grains in the yolk 
of an egg, or a spoonful of molasses, or balsam copaivi in doses of a 
tea-spoonful, or tincture of cantharides in doses of twenty or thirty 
drops in some mucilaginous drink, and taken three or four times 
a-day, will be found most salutary. 

These means strike at the cause of the complaint; but if it do not 
remove the effect very soon, we are not to trust to them alone. For 
once a morbid secretion being excited, it is very apt to continue, 
although the exciting cause cease to operate. 

On this account, we ought, without delay, to have recourse to 
astringent injections, such as a strong decoction of red oak bark, with 
the addition of a little alum or a solution of alum in water. Half 
an ounce of the former to be dissolved in a bottle of water; which 
should be thrown into the vagina by means of a female syringe, two 
or three times a-day. The celebrated Dr. Burns, says, after many 
trials, he satisfied himself, that although assistance may be derived 
from internal medicines and the cold bath, yet the chief dependence 
is to be placed on astringent applications to the seat of the discharge ; 
and these, where there is no fulness of the general system, nor any 
affection of the womb itself, are perfectly safe, and seldom fail in 
producing a cure. 

It will be prudent, when this disease occurs as an early symptom 
of pregnancy, not to check the discharge suddenly, lest miscarriage 
be the consequence; but it may be moderated by injections of water, 
with the addition of a little vinegar, or an infusion of green tea. 
Neither should the discharge be suddenly suppressed when it has 
been of long standing, and acquired a considerable degree of acrimo- 
ny, with an offensive smell. For if it be unseasonably checked, the 
belly swells, and a train of the most disagreeable symptoms occurs. 
In such cases, soap-suds, or an infusion of camomile flowers or 
hops, should be frequently thrown up the vagina ; and as soon as 
the blood is freed of its impurities, by suitable medicines, and has 
recovered, in some measure, its soft and balmy quality of which it 
has been deprived, the astringent injections may be employed with 
perfect safety. 

The application of a blister to the sacrum, has, in some obstinate 
cases, been attended with advantage. 

When the fluor albus proceeds from worms, purgatives and bitter 
clysters are the proper remedies. 

Pain in the back and loins is often mitigated by the application of 
a large adhesive or strengthening plaster, and by avoiding a standing 
posture of long continuance, much walking, dancing, or any other 
violent exertion. 

Women should carefully avoid all the remote causes of the disease : 
they should pay diligent attention to cleanliness, by washing the 



412 MANAGEMENT OF FEMALE COMPLAINTS. 

parts frequently with cold water ; add when there are excoriations, 
milk and water, or lead-water, may be employed as a wash. 

Dr. Dewees on this subject is very high authority. His plan of 
treatment consists in washing the parts with warm water three or four 
times a-day — in gentle aperients — and a milk and vegetable diet, 
with tincture of cantharides till strangury is produced. And when 
the discharge has become thin and more abundant (and not till then) 
he uses injections of acetate of zinc six grains to the ounce of water — 
or of sulphate of copper, three grains to the ounce of water, three 
times a-day, always carefully washing out first the vagina with soap 
and water. 

Without strict attention to cleanliness, the best plan of treatment 
will be productive of but little benefit. 

Regimen. — The diet should be light, cordial, and nourishing, 
consisting of isinglass dissolved in milk by boiling it, jellies, custards, 
rice, milk, soft-boiled eggs, gelatinous broths, and light meats, together 
with a prudent use of genuine wine, particularly claret or port. 

Women, affected with this disease, should by no means indulge in 
the use of tea and other warm slops of a relaxing nature; but should 
lie on a mattress in preference to a feather bed ; and they should rise 
early, and take such daily exercise as their strength will admit, par- 
ticularly on horseback. When there is much languor, with chilli- 
ness, friction with the flesh brush, and wearing flannel next the skin 
must not be omitted. 



PREGNANCY. 

The great varieties of the female constitution occasion pregnancy 
to be, to some of the sex, of no trouble or distress, through the 
whole period of child-bearing ; but it is to others often a continual 
disease, being, perhaps, from the very first week to the last of their 
pregnancy, more or less disturbed in their frame from the peculiar 
irritability of their habits. 

Some feel, very soon after conception, such an alteration in the 
state of the stomach, or in their sensations in general, as apprizes 
them of their situation. The woman is troubled with heart-burn, 
acidity, want of appetite, or disgust at her usual food, and sometimes 
has a craving for things she formerly did not desire. She is usually 
sick in the morning, and generally vomits after she gets up, though 
some have no sickness till the afternoon. Sudden qualms and feel- 
ing of faintness, with or without an inclination to reach, occur at 
different times in the day. The bowels also generally become 
bound. Some, instead of being sick, or in addition to the fits of 
sickness, are troubled with a constant desire to spit, with toothache, 



MANAGEMENT OF FEMALE COMPLAINTS. 413 

water-brash, cough, nettle-rash, or other affections. But the time 
to which these extend, varies, as well as the period at which they 
take place. 

In the young and healthy constitution, one of the most early 
symptoms of the incipient stage of pregnancy, is an uneasiness in 
the breasts, somewhat differing from what she may have been ac- 
customed to on the eve of menstruation, and soon attended with 
some sensible addition to the natural fulness and weight, as well as 
with a particular change in the appearance of the areola, or dark 
circle round each nipple. The nipples also soon become more pro- 
minent, the bulbous or glandular eminences around them enlarge, 
and a milky fluid will stain the linen, which had not been observed 
before. 

These occurrences may justly excite in the mind, the first appre- 
hension of pregnancy; after which, the interrupted course of the 
menstruation generally establishes the certainty of the situation. 
Obstruction, however, it must be recollected, may take place from 
other causes : hence, though we conclude, that she who is regular is 
not pregnant, we cannot infer, to a certainty, that she who is ob- 
structed has conceived. A woman in good health may accidently 
be obstructed for one or two periods ; but, in this case, the other 
signs of conception are usually absent, and, at all events, prudence 
will dictate the necessity of patience till the fourth month. In bad 
health, the courses are often stopped ; but, in such circumstances, 
the appearances of pregnancy are absent, whilst the symptoms of the 
accompanying disease point out the nature of the case. There is a 
situation in which there may, for a time, be some ambiguity, and 
that is where the woman has actually conceived, but the embryo has 
almost immediately perished, yet has not come away, but, together 
with some blood in the womb, is converted into a pretty firm, but 
shapeless mass, called a mole or false conception. 

About the end of the fourth month, or a little sooner or later, in 
difficult cases the motion of the child is perceived, and this is the 
most satisfactory of all the signs ; but those who are anxious to think 
themselves pregnant, when they really are not, are apt to mistake 
wind, passing along the bowels, for the motion of the child. 

The motion is at first gentle, it is felt pretty low, and resembles a 
gentle fluttering. The sensation is peculiar, and not imfrequently 
is, at first, accompanied with sickness, faintishness, or hysterical af- 
fections. It may be felt by night or day, and may either be repeated 
pretty regularly, or may not be again observed for two or three days. 
It is called quickening, not because the child at this time begins to 
live, for it is alive from the first, but because it can now move, or its 
motion is not till this time perceptible. 

Nature would seem, by these early notices, to put the mother im- 
mediately upon her guard, that she might not disturb the tender 
embryo, by avoiding the occasions of either sudden alarm, fatigue, 
fever, or whatever might derange the equitable state o( her health 



414 MANAGEMENT OF FEMALE COMPLAINTS. 

and by attending to those means for its preservation, which are best 
suited to her particular constitution. 

At the end of five months, the infant's size is nearly double what 
it was at the completion of four months, and the size is again nearly 
doubled by the commencement of the eighth month. At the full 
time, or nine calendar months after conception, the ordinary size of 
the child is twenty inches in length, and seven pounds avoirdupois 
weight. But there are deviations from this standard. Some do not 
exceed sixteen or seventeen inches in length, and five pounds in 
weight ; while others weigh nearly fourteen pounds, and measure 
above twenty-four inches. This difference in size and weight ren- 
ders it extremely difficult, and it may be said impossible, to deter- 
mine, in many cases, whether the infant have attained to its matu- 
rity or not. The ordinary marks of hair on the head, nails on the 
fingers and toes, usually depended upon by those unaccustomed to 
consider this subject, are quite fallacious ; and although there be cer- 
tainly marks by which it can be unequivocally determined when the 
infant has not exceeded the sixth month and a half, it would be an 
imposition on the credulity of mankind to allege, after the seventh 
month, the exact age of the infant could be ascertained by its general 
appearance, or its size and weight. 

To protect the child, while in the womb, from the numerous acci- 
dents to which it might be exposed from the exertions or imprudences 
of the mother, a most simple and effectual apparatus is provided. 
Not only is it enclosed in a bag, and surrounded by a quantity of 
water; but it is also nourished by means of a substance similar to a 
sponge, by which the blood of the mother does not run directly into 
its system. 

The infant lies generally with its head down-most, that is, to- 
wards the mouth of the womb, and with its limbs so bent and folded 
together, as to occupy wonderfully little room, like the chick in the 
egg just before it breaks the shell. When there are twins in the 
womb, each infant is included in a separate bag, and attached to its 
own after-birth. The head of the one infant lies towards the breach 
of the other. 

By means of the apparatus thus imperfectly described, it may be 
understood that the infant, while in the womb, is admirably defended 
from external injuries ; but it may not be very obvious how it is 
nourished, and by what contrivance its increase of bulk is accom- 
plished. There is every reason to believe, that the after-birth serves 
the purpose ; and, accordingly, the quantity of blood sent to it al- 
ways keep pace with the size of the child. Thus, in the early 
weeks, the vessels which run from the womb to the after-birth are 
not larger than the hairs of the head ; while, in the latter months, 
many of them are as large as an ordinary writing quill, and the 
number of vessels always corresponds with the extent of its surface ; 
for at every period of pregnancy, it is found, that a separation of the 



MANAGEMENT OP FEMALE COMPLAINTS. 415 

slightest portion of the after-birth is productive of the bursting of nu- 
merous blood vessels. 

That the derangement of the general system during pregnancy is 
produced by the new actions which take place, for the purpose of 
supplying the infant with the principles of life, is rendered probable, 
by the fact, that the breeding symptoms cease from the moment the 
infant dies, and by the additional fact, that they most commonly are 
less and less severe the more children a woman has. Accordingly, 
the ordinary complaints during pregnancy seem to be the immediate 
effects either of a disturbed action of the stomach and bowels, or of 
the formation of too much blood. 

The most important circumstances to be attended to in the inci- 
pient months of pregnancy, is the costive habit of the bowels. Its 
prevention will subdue, if not wholly keep off, some of the trouble- 
some complaints of the stomach, and will often guard most securely 
against some of th« exciting causes of early abortion. 

Blood-letting, cautiously used, either to reduce a too plethoric state 
of the general habit, or to alleviate some morbid affection, is a salu- 
tary agent ; but it is, in general, more frequently had recourse to in 
pregnancy than it should be, upon very erroneous principles. Be- 
cause a pregnant woman, though by one of the established laws of 
nature, is now obstructed, they conceive it proper to draw blood, that 
the constitution may be freed of an imaginary redundancy, not re- 
collecting the process of pregnancy is going on, to employ the inter- 
rupted menstrual fluid, to the now essential purpose of affording 
growth and support to the increasing womb itself, as well as to its 
contents. All the temporary benefits to be derived from blood-letting 
may be most safely and permanently attained by a due attention to 
the diet, and to the state of the bowels. 

Nothing can be of greater importance to a pregnant woman, than 
cheerfulness. They should, therefore, not be depressed by the re- 
lation of any unpleasant intelligence. Some women are often greatly 
disturbed by the account of misfortunes which have happened to 
others in the same situation. The impression made on a timid mind, 
may remain during the whole state of pregnancy. The general 
health may be thus impaired, and the approach of labour too much 
dreaded, so that both body and mind are in a less favourable state 
than they would otherwise have been. It should be considered, 
that though difficult and dangerous cases now and then occur, they 
most commonly terminate well, if properly treated, and their number 
is exceedingly small, when compared with the multitude of women 
who are delivered ; and it is probable it would be still smaller, if the 
cautions above laid down were properly observed. 

We would farther caution women against having recourse to cor- 
dials, to raise their spirits when low. Their good effects are, at best, 
but temporary, while they are ultimately baneful to their constitu- 
tion; and the use of a small quantity too frequently produces the 
necessity for a larger, until the mother and the unborn infant are in 



416 MANAGEMENT OF FEMALE COMPLAINTS. 

jured by this pernicious practice. The best cordials for lowness of 
the spirits in pregnancy, are pure air, moderate exercise, and a light 
and cautious diet. 

There is another affection of the mind of a different character, 
from which lowness and hysterical indispositions often arise; namely, 
the force of a pregnant woman's imagination. This is often sup- 
posed to reach the infant in the womb, and to occasion marks and 
other deformities. But every mother may feel confident, that Pro- 
vidence has better guarded the unborn innocent, than to have ex- 
posed it to injury, from every variation in the feelings of a parent. 
Even admitting the possibility of such an influence, it could only 
take place at a very early period after conception, while the embryo 
is in its most tender state ; and even then it seems in a manner se- 
cured by nature against the above accidents, by the peculiar provi- 
sion made for its defence in the womb ; but it soon attains a sufficient 
degree of firmness to overcome any sudden or irregular impulse of 
the blood, from which alone such deformities or other blemishes 
could happen. 

The mother should, as much as possible, avoid every occasion of 
terror, on her own account, when any thing alarming occurs ; but 
let her not fear that her child will be marked from thence, or, still 
less, from some hidden operation of a disappointed longing, which 
most generally does not take place until the above-mentioned period 
is past. 

Numberless examples could be produced to convince women, that 
the notion which most of them have, that figures of animals, or other 
extraordinary marks, are stamped on the face or the body of the 
fetus in the womb, by the mere force of the woman's imagination, 
is a gross error. In every instance, it will be found, where a child 
is marked, the supposed cause of it has never been mentioned by the 
mother until after its birth ; and when a woman has really been 
alarmed during her pregnancy, and ventured to foretell her child 
would be marked, she has as uniformly been delivered of her fears 
and her child together, for her prediction has never been verified.* 

* Dr. Moore,, in his " Medical Sketches/' relates a case so strongly in point, 
attended with such singular circumstances, that it is worth mentioning here. 
"A lady who had a great aversion to monkeys, happened, unfortunately, 
during the course of her pregnancy, to visit in a family where one of these 
animals was the chief favourite. On heing showed into a room, she seated 
herself on a chair which stood before a table upon which this favourite was 
already placed. Not naturally of a reserved disposition, and rendered more 
petulant and wanton by long indulgence, he suddenly jumped on the lady's 
shoulders. She was terrified and screamed ; but on perceiving who had treated 
her with such indecent familiarity, she actually fainted ; and though the re- 
maining course of her pregnancy, she had the most painful conviction that her 
child would be deformed by some shocking feature, or perhaps the whole 
countenance of this odious monkey. 

"The pangs of labour did not overcome this impression, for in the midst of 
her pains she often lamented the fate of her unfortunate child, who was 
doomed through life, to carry about a human soul in the body of an ape. 



MANAGEMENT OF FEMALE COMPLAINTS. 417 



DISEASES OF PREGNANCY. 

When we reflect on the several changes in the system which are 
produced by pregnancy, we cannot be surprised that it should be 
the source of disagreeable sensations, and of the cause of many dis- 
eases. No part of the human body is possessed of greater irritability 
than the womb; nor any part the increased irritability of which is 
more readily communicated to the system in general. The breasts 
are so connected with the uterus by their office, that every affection 
of the womb is immediately accompanied by some change in the 
breasts. — Next to the breasts, the stomach most readily sympathizes 
with the womb ; and through the stomach, the head and the heart 
are very soon brought to participate in its changes and complaints. 

Breeding Sickness — When it does not materially impair the 
general health, is to be regarded as a favourable symptom , because it 
certainly tends to prevent the formation of too much blood in the 
early months, which is one of the chief causes of abortion. It is 
generally sufficient to keep the bowels open. But when it becomes 
troublesome, it is necessary to interfere in time, otherwise alarming 
nervous complaints may be induced. 

The most effectual means of affording relief in those cases are 
blood-letting, and gentle laxatives regularly administered. The ap- 
plication of mint, (see Materia Medica,) or laudanum rubbed on 
the pit of the stomach, or administered in the form of an injection, 
has sometimes been of service. When sickness arises immediately 
upon first getting out of bed, a cup of tea or coffee often affords relief. 

Costiveness — Is a common attendant on pregnancy, and, if 
neglected, may produce serious consequences. Women in this 
situation should never allow more than one day to pass. without 
having a motion. (See Dyspepsia.) 

Heartburn — Is commonly confined to the early months, but 
sometimes accompanies every stage of pregnancy. A table-spoonful 
of a fluid, prepared by mixing the white of an egg with a little sugar 
and water, so as to make it of the consistence of thin syrup, taken 
occasionally, has, in many cases, afforded relief. When the heart- 
burn is attended with a constant desire to hawk up phlegm, the sto 
mach should be emptied by a gentle emetic. (See this disease.) 

Longings. — Pregnant women have often unnatural cravings, or 
what are termed longings, which, however absurd they may appear 

When the child was born, she called to the midwife with lamentable voice, 
for a sight of her unfortunate offspring, and was equally pleased and surprised 
when she received a fine boy in her arms. — After having enjoyed, for a few 
minutes, all the rapture from this change from pain and misery, to ease and 
happiness, her pains returned, and the midwife informed her that there was 
still another child. "Another," exclaimed she, "then it is as I have dreaded, 
and this must be the monkey after all!" She was, however, once more hap- 
pily undeceived, the second was as fine a boy as the first. 



418 MANAGEMENT OF FEMALE COMPLAINTS. 

on some occasions, are frequently involuntary. They should be 
gratified, if possible, as women are apt to miscarry from the anxiety 
these occasion, when they are not indulged. It will be found, when 
the appetite is feeble, and the powers of digestion impaired, the sto- 
mach often rejects particular substances, and retains others, which, 
though seemingly whimsical, are found to agree with it. 

Fainting Fits. — Hysterical and fainting fits are apt to occur 
about the period of quickening, and, though sometimes attended 
with alarming appearances, are, in general, slight and of short dura- 
tion. A repetition is to be prevented, if the patient be of full habit, 
by keeping the bowels open, taking some blood occasionally, and 
putting her on a spare diet. But, if she be thin, and there be an 
appearance of nervous delicacy, strengthening means, as the cold 
bath, nourishing diet, cheerful society, regular exercise in the open 
air, with attention to the state of the bowels, are the best preventives, 
(See this disease.) 

Palpitations — Is another distressing affection to which some 
women are liable during the whole of pregnancy. 

The treatment of these nervous complaints must be varied accord- 
ing to the constitution and situation of the individual ; but, in gene- 
ral, invigorating diet, moderate exercise in the open air, keeping the 
bowels regular, avoiding every thing that disagrees with the stomach, 
and whatever can agitate the mind, will render the attack less fre- 
quent. (See Palpitation of the Heart.) 

Looseness. — This may occur during pregnancy, and is to be 
treated just as at any other time. (>S*ee Diarrhoea.) However, it 
may be necessary to observe, that women of full habit, especially in 
the early stage of pregnancy, should be very cautious in checking 
it suddenly, as an immediate overflow of blood to the womb may 
be the consequence ; and because such discharges are sometimes the 
effects of an effort of the constitution to throw off some oppressive 
load. 

Difficulty of Urine. — In some cases, during pregnancy, there 
is great pain or heat in making water. This is often accompanied 
by a most troublesome itching at the neck of the bladder, and neigh- 
bouring parts, with fever. In this case, it will be proper to bleed, 
to keep the bowels open with some cooling laxative, to drink freely 
of some diluent liquors, and to wash the parts three or four times 
a-day with lead water, or apply a sponge, wet with cold water, to be 
frequently renewed. 

Another more serious affection is a suppression of urine, at the 
same time that the stools are also obstructed. It chiefly takes place 
between the third and fourth month, and is attended with much 
pain in the lower part of the belly, owing to the distension of the 
bladder, and a feeling of bearing down, like the latter end of labour, 
with a desire of going to stool. 

This complaint consists in a change of the position of the womb, 
which is turned nearly upside down, and is sometimes brought on 



MANAGEMENT OF FEMALE COMPLAINTS. 419 

suddenly by a fall, sudden exertion, or straining at stool, but much 
oftener by retaining the water too long. 

Pregnant women, therefore, should, on no account, place them- 
selves in situations which may lay them under restraint in this re- 
spect, and carefully attending to every call is essential to their safety. 
When the womb has descended very low, the os tincee will be found 
to protrude the external orifice. In this case, the complaint may 
generally be removed by pushing the womb up into the pelvis, and 
and supporting it there while the woman discharges her water. The 
reduction may be effected by the patient placing herself on her hands 
and knees, and then passing two fingers of one hand into the vagina, 
and a finger of the other into the rectum, by which means it is pos- 
sible sometimes to succeed. But even this assistance may be ren- 
dered unnecessary, by trying the effect of different postures, by lying 
on her back, with her hips raised, or kneeling on the floor, with her 
elbows resting on a pillow ; or by lying on either side, either of 
which attitudes may relieve the pressure on the urethra. 

In all cases of strangury, especially if the woman be of a full and 
plethoric habit, flushed and heated, she should lose blood according 
to the urgency of the symptoms. The bowels should be fully 
opened by copious injections, or mild laxatives* She should take 
mucilaginous drinks, and apply warm fomentations externally, or 
sit over warm water. These remedies, when the suppression is only 
partial, will generally afford relief; but whenever total suppression 
takes place, the patient should keep gum Arabic in her mouth, and 
avoid, as much as possible, drink of any kind, until she has been 
relieved ; and, if she do not soon succeed in her endeavours, recourse 
must be had to the catheter without delay. When the womb in- 
creases in size so large as to rise out of the pelvis, these distressing 
symptoms are relieved. 

Too much caution cannot be given to pregnant women on the 
subject of the retention of their urine. Every moment's delay in- 
creases the difficulty, and an hour's neglect may lay the foundation 
of the most painful and distressing complaint. 

Incontinence of Urine.— In the end of pregnancy there is 
sometimes an incontinence of urine, or the woman is obliged to void 
it frequently, but has no pain. This often proceeds from the pres- 
sure of the child's head on the bladder, and is considered as a favour- 
able sign of a natural labour. It can only be moderated by frequent 
horizontal posture, and its bad effects prevented by attention to 
cleanliness, and the use of a thick compress of linen or sponge. 

Swelling of the Feet. — It is usual, during pregnancy, espe- 
cially in the latter end of it, for the feet to swell. It is the effect of 
the enlarged womb preventing the ready return of the fluids from the 
lower extremities. But, when the swelling extends over the knees, 
and more especially when it appears on the upper parts of the body, 
and where it does not entirely subside after having boon a low hours 
in bed, it is to be regarded as a very serious complaint. 



420 MANAGEMENT OF FEMALE COMPLAINTS. 

In the slight degrees, which happen chiefly during a first preg- 
nancy, or when the womb seems much distended, or when the 
woman is rather relaxed, the occasional horizontal posture, when the 
swelling is troublesome, with spare diet and an open state of the 
bowels, are all that seems necessary. But, in the serious degrees of 
the complaint, it is generally found that blood-letting, to a pretty 
considerable extent, and repeated purgatives, can only prevent the 
dangers which might ensue either during labour or after delivery. 
A different kind of swelling of the legs proceeds from an enlarge- 
ment of the veins. The feet are not necessarily swelled ; but along 
the inside of the legs, towards the knees, is a chain of knots of a blue 
color, disappearing by using friction after lying down. This is re- 
lieved by applying a roller, with a moderate degree of firmness, but 
not so tight as to give uneasiness, or affect the circulation. 

Inability to Sleep.— Inquietude and inability to sleep prove 
troublesome complaints towards the latter period of a pregnancy : 
the patient being obliged to rise frequently through the course of 
the night, in order to expose herself to the influence of cool air. 
Nothing affords so great relief, in cases of this nature, as bleeding 
in small quantities, with the occasional use of some cooling laxative 
medicine. Opiates are never attended with advantage in such con- 
ditions. 

Pains — Often occur about the back and tops of the thighs in the 
early part of pregnancy, and frequently are brought on by walking 
rather more than is proper. This requires a state of strict rest for 
some da}rs, and the part to be rubbed with the anodyne liniment y 
.{see Dispensatory^) or, if the pulse be full, and the patient strong, 
some blood should be taken away. 

Another kind of pain affects the back alone, and is of an aching 
nature, with a feeling of weakness. This is often relieved by the 
shower-bath, and the application of a strengthening plaster. 

Towards the latter end of pregnancy, colic pains are often so severe 
as to resemble the throes of labour. If they be not preceded by, 
nor attended with, costiveness, they may be easily remedied by opi 
ates, and a proper regulation of the diet. 

In consequence of the stretching of the muscles, some of the fibres 
may separate, so as to allow part of the intestines to be pushed out 
beneath the skin ; or this may take place at the time of delivery, 
and a pretty large swelling arise on some part of the belly. If the 
opening be large, the bowel is easily pressed back, but starts out and 
renews the swelling whenever the woman walks or even attempts 
to rise. This is called a rupture, and it may also take place at the 
navel, &c. The bowel is to be reduced, and kept in by a well 
adapted but easy bandage, and costiveness is to be prevented. When 
the woman is in labour, and has forcing pains, it is often necessary 
to apply the hand to the part, to keep the bowels from being strongly 
forced out, and after delivery, pressure must be immediately made 
otherwise faintishness may be produced. 



MANAGEMENT OF FEMALE COMPLAINTS. 421 

When the integuments of the belly become cracked and sore from 
over-distention, nothing is so effectual as a frequent use of warm 
sweet oil, by friction. 

Cramps. — Women near the end of pregnancy are subject to 
cramps in the legs, the thighs, &c, which occur most frequently 
when lying in bed. They are occasioned by the pressure of the 
womb ; and, therefore, like the other complaints depending on the 
same cause, they do not entirely cease till after delivery. In slight 
cases, change of posture affords almost immediate relief: when this 
fails, rubbing with a flesh brush or flannel, or the application of cold 
vinegar, opodeldoc, or anodyne liniment, to the affected parts, are 
the best modes of procuring relief. When the stomach is affected, 
the same remedies as advised in cramps of that organ are to be 
employed. 

False Pains. — Many women are afflicted, long before their con 
finement, with pains so nearly resembling those of labour, that they 
often are mistaken for them. They are known by the name of false 
pains. They may affect the back, and come on with regular inter- 
missions, and are peculiarly apt to occur during the night. ' They 
may be distinguished by being rather more irregular and shifting 
than those of labour, or being more early attended with a pressing • 
down. They are also usually accompanied with griping or wind in 
the bowels, or some difficulty in making water. In such cases, con- 
finement in a horizontal position ; bleeding, if plethoric ; laxative 
medicines, if costive ; and administering small and frequent doses of 
some opiate, until the patient finds ease, will be necessary. They 
are sometimes produced by worms, which are removed by giving an 
injection of strong decoction of camomile flowers, with salt, and using 
laxatives. Occasionally they affect the side chiefly, and are accom- 
panied with a great motion of the child. Rubbing the part with 
anodyne liniment sometimes does good. 

Shivering not unfrequently occurs in the end of pregnancy, espe- 
cially in the night time ; and as labour sometimes begins with this, 
it creates an unfounded belief that delivery is approaching. It is 
either unattended with pain, or the pain is irregular, affecting chiefly 
the bowels or sides. It goes off by taking twenty to forty drops of 
laudanum, in a glass of warm tea or thin gruel. 

Convulsions — Are usually preceded by some symptoms which 
indicate their approach, such as a sense of fulness or heaviness in the 
head, severe or even excruciating headache, dimness of sight, or the 
appearance of substances floating before the eyes, sometimes dark, 
sometimes of a fiery brightness. They may also be preceded by 
cramp in the stomach, attended with dreadful sickness. They are 
likewise to be apprehended, if the face and arms be swelled in the 
same way as feet are in ordinary pregnancy. 

At whatever period of pregnancy convulsions take place, we uni- 
formly find, that if they are repeated, and do not prove fatal, they 
bring on labour, or at least open the mouth of the womb. But there 



422 MANAGEMENT OP FEMALE COMPLAINTS* 

are many instances where, by proper measures, the repetition of 
the fits have been prevented, and the patient has safely gone to the 
full time. 

A knowledge of the causes of convulsions cannot be too widely 
diffused, as their occurrence may, in more than the majority of cases, 
be prevented. The formation of too large a quantity of blood, and 
an increased susceptibility of impression of the nervous system, occa- 
sion the tendency of this disease. 9 When these exist in any conside- 
rable degree, circumstances suddenly bring on the fits, which in any 
other condition of the body have little influence, such as over fatigue, 
fright, distress of mind, irritations of the stomach or bowels, over- 
distention of the urinary bladder, or obstruction to the passage of the 
blood through the belly and lower extremities, in consequence of 
the pressure of the enlarged womb. The immediate cause of the 
fits is an overflow, or too great determination of blood to the vessels 
within the head. 

These facts explain the necessity for so regulating the diet and 
exercise during the latter months of pregnancy, as shall prevent both 
too great fulness of the habit, and also impaired energy of the ner- 
vous system. 
# Under proper and active management, convulsions are found to 
be, in general, more alarming than really dangerous. The frightful 
appearances which attend such cases having paralyzed the exertions 
of practitioner's, may perhaps account for the unfortunate event in 
many cases. 

The practice consists chiefly in evacuation. The patient must be 
instantly bled, and the bleeding must be repeated once and again, if 
it do not prove at first efficacious. A prodigious quantity of blood 
has been taken away with advantage, and has been the means of 
saving life. 

Two quarts of blood have been drawn off in the course of twenty- 
four hours under these circumstances, and with a happy effect. 

The bowels are also to be opened immediately by an injection of 
soft soap dissolved in warm water, and then giving a strong solution 
of Epsom salts, or an infusion of salts, senna and manna, every hour 
or two, until copious evacuations are produced. After the first bleed- 
ing the head should be immediately shaved, and a blister of conside- 
rable size should be applied to it. 

When convulsions are dependent on an irritable or excitable state 
of the nervous system, it is not necessary to use the lancet so freely* 

It will be best, after moderate bleeding, to apply leeches to the 
temples, at the same time not to neglect the bowels, which should be 
kept perfectly open. If by these means the disease be checked, the 
camphorated mixture in its usual doses may be given to allay the 
nervous irritation. Por this purpose, opium in the form of a clyster 
has also been recommended. Dr. Denman proposed that a clyster, 
containing six or seven grains of opium, should be administered, un- 
der the supposition that, by putting a stop to the contractions of the 



MANAGEMENT OF FEMALE COMPLAINTS. 423 

uterus, the convulsive contractions in the other parts of the body 
may also cease. 

The warm bath is strongly recommended by Dr. Denman among 
the means of preventing convulsions in women previously to, or 
during their confinement. He also recommends the warm bath in 
labours rendered complex by convulsions, and this upon a long and 
extensive experience. He says, that when convulsions have con- 
tinued or increased, notwithstanding copious bleeding and the use 
of all other rational means, the patient may be put into the warm 
bath, in which she may remain a considerable time, if the convul- 
sions are suspended while she is in it. In instances where a warm 
bath could not be procured, or while it was preparing, he has directed 
flannels, wrung out of warm water, to be applied over the whole of 
the abdomen. 

Dr. D. also observes, that he has seen the patient relieved from 
that state of irritation immediately preceding the convulsion, by dip- 
ping feathers in cold water and dashing it with force on the woman's 
face, as this roused her, and interrupted the progress of the fit. 
Where the farther application of cold water is deemed necessary, 
and appears advisable, we may throw water over the patient's head, 
bringing this over the side of the bed, and holding an empty pail 
underneath to receive it. It should be done on the approach of the 
fit, which may be ascertained by attending to the vibrations of the 
intercostal muscles. 

Discharge of Water — May take place at different times during 
pregnancy, especially in the last two months. The quantity is va- 
riable, and sometimes the discharge is accompanied or succeeded by 
irregular pains. When this is the case, give a dose of laudanum, 
and afterwards some gentle laxative, to prevent costiveness. At the 
same time, the woman should remain quiet in bed. By these means, 
she may go to the full time. If the water continue several days but 
trifling in quantity, a solution of alum or decoction of oak bark, 
should be injected up the vagina two or three times a-day. 

Discharge of Blood — May proceed either from the passage to 
the womb, or from that organ itself. In the former case, no bad 
effects can be dreaded ; but in the latter one, the most serious conse- 
quences may ensue. 

The immediate cause of a discharge of blood from the womb, 
during pregnancy, is the rupture of blood vessels, by the partial or 
total separation of those parts which connect the child with the 
mother. This circumstance explains the difference of danger in the 
early and latter months ; for in the former, the blood vessels of the 
womb being small, are incapable of pouring out. much blood ; but in 
the latter, they are very large, and may discharge, in a short time, a 
great quantity. 

The management of these cases must be varied according to a 
number of circumstances. Tranquillity of mind, and confinement 
to bed in an airy room, lightly covered with clothe-, are of great im- 



424 MANAGEMENT OF FEMALE COMPLAINTS. 

portance. A bladder two-thirds filled with cold water, or cloths 
wrung out of cold vinegar and water, should be immediately applied 
to the lower part of the belly. If the discharge continue in small 
quantities, accompanied with irregular pains, a dose of laudanum, 
or the anodyne clyster, should be administered. When it has sud- 
denly been brought on by a fall, blow, or any great exertion, it is 
necessary to draw blood from the arm ; but when the symptoms 
which threaten miscarriage have come on, it is improper either to 
bleed, or to give laudanum. 

The languor or faintness, usually induced by loss of blood, fre- 
quently lead officious attendants to exhibit spirits of wine, as neces- 
sary cordials. As these generally increase the action of the blood 
vessels, they serve to promote and increase the discharge, and should, 
therefore, be strictly prohibited. In the latter stage of pregnancy, if 
the attacks be severe or repeated, nothing can save the mother and 
the child but delivery, which must not be too long delayed in ex- 
pectation of pains coming on, or of their becoming brisk, if they 
have already taken place. 



ABORTION. 

By abortion or miscarriage is meant the expulsion of the child at 
a period of gestation so early that it cannot live. 

It is always accompanied with two circumstances, separation of 
the membranous bag, expulsive efforts, or contraction of the womb 
itself. The first is productive of discharge, the second of pains like 
those of labour. Sometimes the separation or detachment of part 
of the conception takes place before any pain is felt ; on other occa- 
sions, the pain, or contraction of the womb, takes place first, and 
produces a separation. In the first of these cases, the symptoms of 
abortion take place suddenly, and are usually occasioned by fatigue, 
sudden exertion, or fright. In the second, the child is frequently 
dead a short time before the pains come on, and there are particular 
feelings, and changes, which indicate that a miscarriage is likely to 
take place ; as, for instance, the cessation of the morning sickness, 
the subsidence of the breasts, absence of motion of the child, a feel- 
ing of weight, or heaviness in the lower part of the belly, &c. 

Causes. — Violent exertions of strength, severe exercise, sudden 
frights, violent fits of passion, over-fulness of blood, profuse evacua- 
tions, excessive venery, former miscarriages, a diseased state of the 
uterus, general debility of the system, external injuries, and strong 
acrid and stimulating medicines, which are often taken for the ex- 
press purpose of exciting abortion, and the death of the child. 

Such criminal intentions to destroy the fostus by artificial means 



MANAGEMENT OF FEMALE COMPLAINTS. 425 

can never succeed, unless the most violent effects are produced on 
the organs contiguous to the womb, which seldom fail to produce 
inflammation of these delicate parts, and occasion the death of the 
mother. Whenever, therefore, women commit such unjustifiable 
crimes to conceal the indulgence of irregular passions, their life is 
exposed to the greatest danger. 

Treatment. — When a woman is threatened with a miscarriage, 
there are two objects to attend to : the first is, to prevent it if we can ; 
the second is, to manage it so that as little blood as possible be lost ; 
and both these are obtained by the same means. With this view, 
the patient should immediately, on the first alarm, undress and go to 
bed, lightly covered, with a firm determination not to rise till the pro- 
cess be either checked or completely over. There should be little 
fire in the room, though it be winter; and, in summer, the windows 
must be opened. Cloths, wet with cold water, should instantly be 
applied to the lower part of the belly and back: the drink must be 
cold, and every thing stimulating should carefully be avoided. 

In robust habits, or when the symptoms have been brought on 
suddenly by some such cause as a fall or exertion, it is proper to 
bleed, and, in cases of sickness or great feebleness, to give a dose of 
laudanum ; or, what is better, to administer the anodyne clysters. 
(See Dispensatory.) Opiates are useful in every case where we 
hope to prevent abortion, and must be repeated more often or seldom, 
according to the effect they produce. They are, however, improper 
in those cases where miscarriages must decidedly take place. Their 
tendency to occasion costiveness, when employed, must be obviated 
by clysters, or some gentle laxative medicine, such as calcined mag- 
nesia, Epsom salts, or a little castor oil. If there be a continued but 
trifling discharge, great advantage may be derived from injecting, 
three or four times a-day, up the vagina, a solution of alum. In- 
deed, in all protracted cases, this is of much benefit. The solution 
ought, to be thrown up pretty high, that it may reach the womb. 

When these means produce not the desired effect, and along with 
the discharge of blood large clots come off attended with bearing 
down or pains in the back and loins, especially if the symptoms 
which precede abortion have appeared, there must be every proba- 
bility that the threatening event cannot be avoided ; and then we 
must endeavour to conduct the patient safely through the process. 

In all cases during the last stage of pregnancy, where our endea- 
vours to stop or repress the hemorrhage prove abortive, and the life 
of the woman becomes endangered by its severity, it will be advisa- 
ble to deliver her as soon as possible. If the ovum be still entire, 
and the pregnancy considerably advanced, the expulsive action is to 
be excited by rupturing the membranes. 

When the whole conception come away at once, the pain and dis 
charge usually go off; but, if only the child come away, all the 
symptoms either continue and increase till the after-birth come away. 
or, if they be for a time suspended, they are sure to return. 
54 



426 MANAGEMENT OF FEMALE COMPLAINTS. 

After the process is over, if the discharge be profuse, and do not 
stop on the application of cold water to the lower part of the belly, 
it will be proper to plug up the vagina, and this is best done by tak- 
ing a pretty large piece of soft cloth, dipping it in oil, and then 
wringing it gently. This is to be introduced with the finger, portion 
after portion, until the lower part of the vagina be well filled. The 
remainder is then to be firmly pressed on the orifice, and held there 
some time for the effused blood to coagulate. In obstinate cases, 
previously to the introduction of the plug, we may insert a little 
pounded ice, or snow tied up in a rag, if to be procured ; but neither 
of these should be continued so long as to produce pain or much 
shivering. In addition to this mode of treatment, it will be advisable 
to have recourse to the astringent medicines, as advised under the 
head of Immoderate Flow of Menses. 

Regimen. — Arrow root, tapioca, sago, panado, or rice milk, con 
stitute a proper regimen. If the process be protracted, and the 
strength much impaired, the diet may be more liberal. In every 
case, ripe fruit is safe and useful. The bowels are to be kept regu- 
lar, and sleep, if necessary, is to be procured by an anodyne. 

Prevention. — It requires great attention to prevent abortion in 
subsequent pregnancies, whenever it has happened. 

In all such cases, it will be highly necessary to attend to the usual 
habitudes and constitution of the women, and to remove that condi- 
tion which is found to dispose to abortion. 

A woman that is subject to miscarriage, and who is of a full ple- 
thoric habit, ought to be bled just before the usual time of her mis- 
carriage, and she should take the tincture of foxglove, twice or thrice 
a-day for two or three weeks. In robust habits, blood-letting may 
be repeated every fortnight during the second, third, or fourth 
months ; but the blood should be taken from a small opening, and 
not much at a time, lest fainting be produced. The quantity and 
the repetition must depend on the constitution of the patient, on the 
particular symptoms in the individual, and on the effect produced by 
the evacuation. 

She should likewise keep her body perfectly open with gentle ape- 
rient medicines, use a spare diet, and avoid all agitations of the mind. 
The sleep should be abridged in quantity, and taken on a mattress, 
instead of a feather bed. Regular and moderate exercise should be 
taken daily, being cautious, at the same time, not to carry it to the 
length of exciting fatigue. 

In women of a weak, lax habit, bleeding would be highly impro- 
per; for such, a nutritive and generous diet, moderate exercise, and 
tonic medicines, will be required. And, along with nourishing diet, 
a moderate use of wine should be allowed, if it do not heat the pa- 
tient, or otherwise disagree. The cold bath is of signal service in 
every instance where it is not followed by chilliness. 

Until gestation be far advanced, it would be advisable for the wo- 



MANAGEMENT OF FEMALE COMPLAINTS. 427 

man to sleep alone, and strictly avoid every cause which is ascer- 
tained to be capable of producing abortion. 

Women more frequently miscarry in the second or third month 
than at any other time ; but some have a certain period at which 
they usually go wrong, and do not vary a week from it. In such 
cases, the woman should confine herself to the house, avoid the least 
exercise, and frequently recline on the sofa or bed, till that period 
be past. 

When women miscarry repeatedly about the fifth or sixth month, 
and feel, previously to that accident, the symptom's of the child's 
death, and at the same time, the child, when expelled, is putrid, 
some latent poison, which will probably yield to a mercurial course 
of medicine, may be suspected. 



OF LABOUR. f 



Labour generally happens in about nine calendar months, that is, 
from thirty-nine to forty weeks. In some cases, this time is consid- 
erably shortened, and, in others, is certainly protracted. There are 
two methods of reckoning ; namely : from the time obstruction takes 
place, and from the sensation of quickening. If the former be de- 
pended on, the date of conception should be taken at a fortnight be- 
fore the obstruction ; if the latter be preferred, five calandar months 
may be allowed from the time that the movement of the infant was 
distinctly perceived. 

There are three different steps in the delivery of a child : First, 
the mouth of the womb must be gradually opened; secondly, the 
child must be expelled ; and, thirdly, the after-birth must be thrown 
off. The first of these effects must be accomplished by the repeated 
contractions of the womb, which produce sharp or grinding pains. 
The second is fulfilled by more forcible efforts, productive of bearing 
down pains, which at last, increase to great severity. The third 
takes place a short time after the child is born, and is attended with 
very slight pain. 

These pains proceed from the attempt made by nature to dilate 
the mouth of the womb, and they must continue until this be accom- 
plished. The complete dilatation is assisted and rendered both easier 
and frequently more speed}', by the protrusion, through the mouth 
of the womb, of part of the membranous bag, which contains the 
child and the water. The degree to which it is pushed out of the 
womb, during a pain, varies much in different cases. Sometimes it 
forms a very slight projection, at other times is very bulky, being 
little less than the child's head. When the membranes begin (o be 
pushed, the water is said to " gather." 



428 MANAGEMENT OF FEMALE COMPLAINTS. 

The mouth of the womb being considerably opened, efforts are 
next made to press down the child, or to empty the womb. These 
produce a change in the pains, which are attended with a little incli- 
nation to press down. This gradually increases, and at last, the 
sensation of bearing down becomes very strong and irresistible ; and 
it is observed, that, though the pains are strong and forcing, they are 
productive of less complaint than those which, in the beginning of 
labour, appeared to be less severe. There is a great variety in the 
duration of this part of the process. It is sometimes gradual and 
slow, in other cases sudden and rapid. The pains may be strong 
and forcing, and have very little interruption, or they may come on 
at very regular periods, with complete intervals of ease. 

During this period the membraneous bag, in which the child lies, 
usually bursts, and the water which it contained is discharged. This 
event is followed by an increase of the pain, which becomes more 
forcing, and the spirits of the woman rise in proportion. At length 
the head of the child comes to the birth, and, by repeated efforts, is 
at last expelled. This is followed by the gradual delivery of the 
body. After an interval of ease, one or two slight pains are felt, 
which serve to throw off and expel the after-birth. The duration 
of this process is various, but it is generally longer in a first child 
than afterwards. This is particularly the case with regard to the 
second stage. Some women are uniformly expeditious, others al- 
ways tedious. Some have the first stage slow and the second quick ; 
some have the water discharged early, others not until the child is 
born. Some have much sickness, or retching, or shaking, others 
none at all. In short, there is great variety in these respects with 
different women, or even with the same woman in different labours. 
In a natural labour, the whole process is concluded within twenty- 
four hours after its commencement, often in a much shorter period 



PROGRESS OF LABOUR. 

When a woman, after a preceding day of ease, an unusual acti- 
vity, about the period of her reckoning, begins to feel some restless- 
ness about her, with occasional pains in her loins and side ; if she 
farther perceive that the bulk of her belly has fallen, that the motion 
of the child has not been for some time so sensibly or frequently felt, 
and that she has a nervous hurry of spirits upon her, with a feverish 
glow of heat, she may then conclude that nature feels an inclination 
to prepare her for the termination of her pregnancy. 

When labour has actually commenced, the bed on which the 
patient is to be delivered, should be properly prepared, that it may 
not remain wet and disagreeable after the delivery. It should be 



MANAGEMENT OF FEMALE COMPLAINTS. 429 

placed in such a situation that the room may be ventilated, without 
the patient being exposed to a current of air. The mattress is to be 
put uppermost, as being more comfortable than a feather bed when 
it is not daily made up. A folded blanket, or dressed sheep-skin is 
put next to this, in order to prevent it from being wet and soiled. 
Over this the undermost bed sheet is thrown, and the bed made up 
as usual. Afterwards, a sheet, in five or six folds, is laid across the 
bed ; and these being removed when the child is delivered, and the 
woman is laid up, she finds herself clean and dry, without farther 
trouble. 

Every thing ought to be in readiness before it can possibly be 
needed, particularly the baby-linen, and such articles of dress as the 
mother may require. The dress of the woman, during labour, ought 
to be as light and as simple as possible, and so prepared, that it may 
not be necessary to disturb them soon after delivery by a change of 
apparel. When this is properly managed, they avoid an unreasona- 
ble fatigue, and the hazard arising from linen which may not have 
been cautiously aired. Little things are often of great importance, 
and are sometimes found so when it is too late. 

Premature labour is sometimes threatened by pains, which pro- 
duce, for awhile, some real change in the womb sufficient even to 
give the practitioner just reason to expect that they will terminate in 
the delivery. But things again recover their pristine state, the alarm 
of nature subsides, and the woman proceeds in her pregnancy, for 
several days longer, and sometimes for weeks. 

As the change in the womb above mentioned does certainly occur, 
even on a false alarm, it should put young and female practitioners 
on their guard, lest they promote labour too hastily, either by gene- 
ral treatment, or any manual operation ; for these would only fruit- 
lessly tease the patient, when the judicious exhibition of an anodyne 
would do every thing that can be wished for. 

When, in consequence of irregular premature pains, the mem- 
branes containing the water with which the child is surrounded have 
been broken before labour has really commenced, it must be ex- 
pected soon to take place ; though if the pains should have entirely 
ceased, on the discharge of the waters, it may be delayed for some 
days : but it most frequently happens within twenty-four hours. 
There is nothing in this circumstance alarming. It may occasion 
the first part of labour to be more slow, but not in any degree less 
safe in the end. It arises wholly from the fineness of the mem- 
branes, which contain the waters, and which must rupture in every 
labour, at some period or other, and hence the waters are unexpect- 
edly discharged, in a sudden manner, without the least preceding 
pain. 

In a slow labour, especially if it be the commencement, the time 
commonly spent in the lying-in apartment, might, with more pro- 
priety, be passed in the usual domestic habits. It would serve to 
lessen the too anxious expectation of a speedy delivery, as well as to 



430 MANAGEMENT OP FEMALE COMPLAINTS. 

prevent the impatience of the attendants, both of which are often 
improperly indulged. 

A sensible woman should always consider that, in a slow labour, 
she may be afflicted with many distressing, or what have been called 
false or spurious pains, but there are very few by which nature does 
not mean some good in the end. She must, therefore, give her 
mind to patience, as all unnecessary interference would rather retard 
than assist the labour, and will only be employed by the designing 
or unskilful. 

In the first stage of labour, the bowels should, if necessary, be 
emptied by means of a clyster, or a dose of some gentle aperient 
medicine. This is attended with several advantages : it renders 
delivery easier, and sometimes promotes it sooner. All heating 
drinks and stimulants are carefully to be avoided, as they increase 
the natural tendency to fever which women have at that time, and 
the temporary vigour they induce is soon followed by a great degree 
of languor, that retards the delivery. 

Violent agitations of the body must be carefully guarded against, 
that the waters may not be discharged prematurely, which might be 
productive of the worst consequences. For these reasons, the fre- 
quent interference of the practitioner in the beginning of labour, 
except where there is some unusual resistance to the opening of the 
womb, or the water has drained off too early, might do much harm, 
and could be attended with no good effects. At that period, no 
medicine, or rather expedient for increasing the force of the pains, 
should be prescribed, as the more slowly the passages are enlarged 
the less injury will the patient suffer. In every instance she should 
be kept quiet and cool, though she ought not to be confined to one 
position. She may be allowed to stand, walk, or sit, or remain in 
bed, as may be most agreeable to her feelings ; but she ought, by no 
means, to stand so long, or walk so much, by way of forwarding the 
labour, as is productive of fatigue, and, after the pains become very 
frequent and pressing, it will be, in general, most prudent not to 
come out of bed. 

Second Stage. — When the first stage is nearly completed, the 
woman should be placed on her left side in bed, with a folded pil- 
low between her knees. 

The bearing down pains, by which the child is forced through 
the passage, should be the effort of nature alone, and ought not to 
assisted by the exertions of the mother : for, in that event, either the 
delivery might be hurried on before the passages are sufficiently 
prepared, or the woman would be much worn out that she could not 
undergo the necessary fatigue that attends the complete expulsion 
of the infant. 

This important caution cannot be too strongly inculcated ; for in- 
attention to such conduct, and the impatience w T hich women in such 
situations cannot perhaps avoid, often make a labour difficult and 
painful, that would otherwise have been natural and easy. 



MANAGEMENT OF FEMALE COMPLAINTS. 431 

Voluntary bearing down must be particularly guarded against at 
the time when the head of the child is only prevented from being 
born by the soft parts at the outlet of the basin ; for, if the delivery 
(lien be hastened, these parts may be readily torn. The utmost at- 
tention of the practitioner is indispensably necessary to prevent so 
unfortunate an accident, in every case where, from the acute feel- 
ings of the patient, violent bearing down at that period cannot be 
resisted. When the child's head presses against the perineum, it 
should be supported by gently pressing with the hollow of the hand 
during the pain, to prevent its tearing. 

After the head of the child is excluded, the woman should be 
allowed to enjoy, for a little time, the temporary relief she feels, and 
therefore, the body ought not to be immediately taken out with 
force, as is often done ; for, besides the injuries which may be occa- 
sioned by not allowing the patient a little rest, the extraction of the 
after-birth will be thereby rendered difficult. Two or three minutes 
may therefore be allowed to elapse before the body be drawn forward. 

If the patient have a rapid labour, and the midwife be at a dis- 
tance, she ought to keep constantly in bed, and refrain, as much as 
possible, from bearing down. If the child should be born before 
assistance be procured, the most experienced woman present should 
take the navel-string between the finger and thumb, and as soon as 
she finds the pulsation in the cord stopped, tie a string firmly near 
the navel, and apply another ligature about three inches from the 
first, and cut the cord between these ; or, if she be afraid to do this, 
the child must lie beside the mother till the midwife come, taking 
care that the face be uncovered, to permit of breathing. 

We will now suppose the woman is just safely delivered of her 
child, and that a complete cessation of the regular pains has followed. 
She must now endeavour to calm that disturbance of the whole 
frame, which, added to her anxiety of mind before the delivery, had 
excited a great degree of heat and perspiration, especially if it should 
have been her first labour, or one attended with some unusual diffi- 
culty. In this state she must not let herself chill or cool too fast. 
It may, perhaps, have been necessary to throw off the bed-clothes, 
during the last hour or two ; if so, they should immediately, on the 
birth of the child, be lightly placed over her again. She may now 
moisten her mouth with a cup of tea, grit gruel, or barley water, 
for either of which she will feel desirous, if she have not been fre- 
quently taking one or the other during the latter part of her labour ; 
but they must be given to her without wine or brandy. If she feel 
herself disposed to sleep, she should indulge it : at all events, she 
should keep herself quiet, and not encourage conversation. For it 
may be observed, that, in general, the mind of a woman newly de- 
livered of her first child, is so occupied with the novelty, as well as 
the anxiety of her situation, that her attention is long kept alive, and, 
therefore, she can scarcely sleep, though exhausted by the fatigue of 
her labour. 



432 MANAGEMENT OF FEMALE COMPLAINTS. 

In the third Stage — The midwife must carefully attend to the 
degree and force of contraction, which the womb is disposed to take 
on immediately, or soon after, the birth of the infant. The experi- 
enced practitioner will, indeed, have a presentiment, even while it 
is coming into the world, of what is likely to take place afterwards, 
from the manner in which the expulsion of the infant is completed. 
This should be effected slowly, as we have already observed, because 
sucli a practice favours that kind of action of the womb necessary to 
detach the placenta. Premature or active endeavours to loosen it, 
must, however, be avoided, if its separation should not readily take 
place, by the seasonable contraction of the womb. Let the opera- 
tions of nature be watched, and she will prove the surest guide, 
though in this part of the delivery, she ought never to be wholly 
depended on. 

We generally find, when there has not been any sudden or hurried 
delivery of the infant, the after-birth is soon expelled without any 
assistance. 

The vessels which passed from the womb to the after-birth would, 
when this was separated, pour an increased quantity of blood, did 
not the womb contract so much as to diminish their size and compress 
their orifices. This contraction both expels the after-birth and pre- 
vents flooding. When, therefore, the after-birth is expelled, we have 
an evidence of the existence of that state of the womb which ensures 
the safety of the mother. 

A woman should, however, avoid expressing any impatience about 
this, as it might induce some practitioners to use that despatch which 
many have done, that the patient or her friends might not insinuate 
that they were a long while in bringing away the after burden. 
This kind of censure is too frequently passed upon the just conduct 
of the midwife, from the improper prejudice too often indulged in 
favour of a speedy delivery of the placenta. Women are apt to deem 
that practitioner most skilful who is the shortest time in finishing that 
part, of her labour. Fatal, therefore, have sometimes been the con- 
sequences of this ill-judged management, particularly among the 
female practitioners. 

It is a mistaken idea, that, in general, some external mechanical 
force is necessary in order to expel the placenta. We cannot, there- 
fore, approve of the modes occasionally recommended, of coughing, 
sneezing, blowing on the back of the hand, or making general pres- 
sure over the belly, with a view of helping its descent, by any kind 
of tight bandage applied to the abdomen, immediately after the birth 
of the child. 

There is a general action of the hand on the abdomen, which the 
patient herself may perform, and by which the uterus is tenderly 
excited to contract, and the placenta of course detached in the most 
favourable manner, that will be found more useful than a bandage, 
or any extraordinary exertions of the patient, for this purpose. But 
as this may not be necessary in every case, it must be left to the 



MANAGEMENT OF FEMALE COMPLAINTS. 433 

judgment of the practitioner to direct, with the proper caution to be 
observed in the applications. 

We would farther observe, that there can hardly ever be occasion 
for a woman to bear down during the delivery of the placenta. In- 
deed, on many occasions, it must be carefully avoided, lest it should 
produce, or increase, a disposition to the prolapsus uteri. The 
throes, which take place naturally, are caused by the contractions of 
the womb ; and with them alone the practitioner can, generally, in 
due season, safely bring it away. 

When the effects of nature do not tend to disengage the secundine 
within an hour after the birth of the infant, the interference of art 
ought to be submitted to. For if it be not thrown off within a short 
time after the infant is bom, it becomes putrid, and induces an alarm- 
ing fever, from which few women have recovered. In assisting the 
expulsion of the after-birth, unless the practitioner wait for the con- 
traction of the womb, that part may be turned inside out. This cir- 
cumstance should be properly understood by all those who happen 
to be out of reach of regular assistance ; for the patient's life, after 
an easy labour, may be destroyed by the rashness of an ignorant 
practitioner. By explaining, however, the case of danger, those 
who are prevented from being under the care of persons of skill, 
may thereby escape those hazards to which they might otherwise be 
exposed. 

The after-birth is generally fixed to the bottom of the womb, and 
as the greater portion of the womb, at the full period of pregnancy, 
is not attached to the adjoining parts, if the navel-string be violently 
pulled before the after-birth be separated, the womb must be turned 
inside out, the ordinary consequence of which is fatal. 

When the grinding pains are felt by which the contraction of the 
womb is distinguished, the practitioner should assist by pulling gently 
the navel-string during a pain, and by endeavouring to bring down 
the after-birth through the basin, in such a manner that its progress 
may not be interrupted by any of the neighbouring parts. 

Until the after-birth is expelled, the patient and midwife should 
be attentive lest there be a great discharge, and if this occur, no 
time is to be lost in checking it. This is done by exciting the con- 
traction of the womb, by the application of cloths wet with cold 
water, to the lower part of the belly and to the passage, or by pour- 
ing cold water out of a pitcher from a height on the abdomen ; and 
also by the introduction of the hand of the midwife to stimulate the 
womb. Some do this with the sole object of extracting the placenta 
or after-birth, considering the retention of this as the cause of the 
flooding. But this opinion is wrong, and the mere extraction of the 
placenta can only do good, so far as the introduction of the hand and 
the means used to effect this, serve to excite the action of the womb 
itself. 

We do not approve of a free and indiscriminate use of greasy ap- 
plication, in the progress of labour. They are wholly unnecessary 
55 



434 MANAGEMENT OF FEMALE COMPLAINTS. 

in the first stage of it, and in the latter part they interfere with the 
changes which then take place naturally, and produce that mucous 
secretion by which the parts are most favourably lubricated, for the 
easy termination of the labour. But after the complete removal of 
the placenta, it will be proper to apply a small quantity of pomatum 
or fresh lard, to defend the parts from the acrimony of the ensuing 
discharges. 



LABORIOUS LABOUR. 

When the delivery is not completed within twenty-four hours from 
its real commencement, though the head of the child be forced fore- 
most, it is styled laborious labour. It may occur under three different 
circumstances. First, the pains may be, from the commencement, 
few and weak, and the labour may, if left to itself, be long becoming 
brisk. Secondly, the pains during the first stage may be sharp and 
frequent, but not effective, in consequence of which, the power of 
the womb is worn out before the child has advanced far, or come 
into a situation permitting it to be expelled. Thirdly, the pains, 
during the whole process, may be strong and brisk, but for some 
obstacle the delivery may be either greatly protracted, or rendered 
altogether impossible, without assistance. 

Different causes may produce these states; such as general weak- 
ness of the constitution, particularly the action of the womb itself, 
premature discharge of the water, fear, impatience and strong passions 
of the mind. 

When the first stage of labour is protracted, and the pains do but 
little good, a clyster has often had the happiest effect in exciting more 
brisk and productive action. In like manner, a change of posture, 
or walking a little in the room, has sometimes rendered the pains 
brisker. But whenever sitting or walking produces fatigue, or is felt 
to be disagreeable, they certainly do harm. 

The most powerful means we can employ for remedying some of 
those conditions, which give rise to tedious and severe labour, are 
blood-letting and the use of laudanum, either in the form of a 
draught or clyster. The states requiring or admitting of these it is 
impossible to explain here ; but it may be a service to do away a 
prejudice which may exist against their employment, when they are 
necessary. Opiates are serviceable sometimes, as cordials or general 
stimulants ; at other times they are beneficial by suspending the use- 
less, but painful action, of the womb, and thus allowing time for the 
strength to recruit, and these effects they produce more safely and 
effectually than any other means could do. They are also of effi- 
cacy in checking that irregular spasmodic action of the uterus, which 



MANAGEMENT OP FEMALE COMPLAINTS. 435 

gives much pain, and rather retards than forwards the expulsion of 
the infant. 

With regard to blood-letting, there is only one objection of any 
weight, namely, that it will weaken the patient ; but, in reply to this, 
we observe, that if it have the effect of rendering the delivery more 
speedy and safe than it otherwise would be, it will rather save the 
strength by preventing unnecessary fatigue. It is also well known, 
that a much greater quantity of blood is often lost after delivery than 
would have been taken from the arm, and yet no bad effect what- 
ever follows from it. When convulsions occur during labour, or in 
the end of pregnancy, six times the quantity of blood that would be 
taken in any other situation, are often extracted with present relief 
and future advantage. Last of all, the experience of different ages 
and various countries proves the safety of the practice. It is not a 
remedy newly introduced, the effects of which we are ignorant of, 
for it is even the habit of some to bleed women in natural labour in 
order to render it still more easy and expeditious. Blood-letting is 
also a powerful means of preventing local inflammation, which may 
be excited by protracted labour. 

In difficult labour we must always pay due attention to the state 
of the bowels, and we should also be very attentive that the urine be 
voided regularly. There are some unfavourable positions of the 
head, which may be rectified by the finger without giving pain. 

If, notwithstanding all our care, the labour be protracted until the 
strength be impaired, and the pains are ceasing ; or, if the obstacle 
be so great as, during the course of labour, to make the head be 
£xed within the bones of the pelvis, and produce suppression of 
urine, or a tender state of the soft parts, with a sense of tightness 
within the pelvis, restlessness, giddiness, or pain in the head, severe 
pain, or feeling of pinching, even in the absence of the labour pain, 
about the share bone, or other symptoms indicating that the powers 
of nature cannot any longer be safely trusted to, it will be necessary 
to have recourse to the use of instruments. These are never to be 
resorted to except in cases of absolute necessity ; but it cannot be too 
strongly enforced on the mind of the patient who requires them, 
that, if she delay, after they have been advised by a practitioner of 
judgment and integrity, her own life, as well as that of her child, 
may be lost. 



PRETERNATURAL LABOUR. 

When any other part of the infant than the head is forced fore- 
most during labour, the case is styled preternatural, or, in common 
language, a cross-birth. Where neither the head nor lower parts 



436 MANAGEMENT OF FEMALE COMPLAINTS. 

are placed next the passage, nature cannot, in general, accomplish 
the delivery ; and, therefore, the life of the woman must depend on 
the position of the infant being changed. The operation by which 
this is performed, is called, in the language of midwifery, turnings 
and consists in bringing the feet into the passage. 

When the case is discovered before the water is drained off, the 
operation of turning may be had recourse to with perfect safety, pro- 
vided the woman be in good health, and without occasioning much 
pain to the patient or trouble to the practitioner. But when, either 
from the restlessness of the patient, or from the improper interference 
of the practitioner, the water has been evacuated at an early period 
of the labour, the life both of the woman and infant must be exposed 
to considerable hazard. In this case the turning is not to be at- 
tempted till, by the administration of sixty or eighty drops of lauda- 
num, the pains are suspended. A neglect of this rule may be fol- 
lowed by very serious consequences. 

Dr. Denman relates three cases of the upper extremities present- 
ing, and the delivery being partly effected by the spontaneous evo- 
lutions of the child. In the first case, the woman had been in labour 
during the whole night, and one of the child's arms was the pre- 
senting part ; on attempting to turn the child, the pains were too 
violent to admit the introduction of the hand into the uterus. Ima- 
gining that the child was small, so that it might pass, doubled, 
through the pelvis, farther endeavours to turn were omitted, and, on 
waiting a little, the breech presented, and the head was the last part 
that was delivered. In the second case, the presentation was the 
same as in the first, and it was agreed on to turn the child ; but the 
pains were strong and frequent, so that the action of the uterus was 
such as to forbid all endeavours that way. It was then agreed to 
wait for the effect which a continuance of the pains might produce, 
or till they were abated, when the child might be turned with less 
difficulty. The pains continued and propelled the child lower in 
the pelvis, and in little more than an hour it was born, the breech 
being expelled, as in the first case. In the third case, the arm pre- 
senting, and labour gone on for some time, after which attempts 
were made during several hours to turn the child, whose shoulder 
strongly pressed upon the perinseum. At length, by the action of 
the uterus, the child was doubled and the breech expelled ; after 
which the shoulders and head were extracted. In all these cases, 
the Doctor observes, that the women were at the full period of utero- 
gestation, and the children were of the usual size. More cases might 
be related, but these sufficiently prove the fact, that, in cases in 
which children present with the arm, women will not necessarily 
die undelivered, though they are not assisted by art. With respect 
to the benefit we can in practice derive from the knowledge of this 
fact, it may be observed, that the custom of turning and delivering 
by the feet in presentations of the arm, will remain necessary and 
proper in all cases in which the operation can be performed with 



MANAGEMENT OF FEMALE COMPLAINTS. 437 

safety to the mother, or give a chance of preserving the life of the 
child. But, when the child is dead, and when we have no other 
view but merely to extract the child, to remove the danger thence 
arising to the mother, it is of great importance to know that the child 
may be turned spontaneously by the action of the uterus. If we 
avail ourselves of that knowledge, the pain and danger which some- 
times attend the operation of turning a child, may be avoided. 

Some propose bleeding ad deliquum for abating the too strong 
contraction of the uterus, and, at the moment of fainting, to attempt 
delivery. 



PLURALITY OF CHILDREN. 

It has been supposed when women have conceived twins, there 
are certain symptoms before delivery by which that circumstance 
can be ascertained ; but there are no sure indications of the existence 
of a plurality of children till after the birth of one child, when this 
takes place, it is very easy to determine when any other remains. 
This may commonly be done without having recourse to the painful 
and indelicate means that have been proposed and practised : for, by 
feeling the state of the belly alone, a judicious practitioner can be 
very seldom mistaken on such occasions. 

When only one child has been originally contained in the womb, 
that organ, soon after delivery, diminishes very much in size, while 
the bowels, which are kept out of their natural situation, in the lat- 
ter months of pregnancy, immediately get forward to the fore part 
of the belly, and render it soft and yielding. But, when a second 
child remains, the womb does not apparently diminish in size. The 
intestines, therefore, remain behind and at the sides, and the fore 
part of the belly has the same hardness as before delivery. It some- 
times happens that the pains advance rapidly, and the second infant 
comes very soon after the birth of the first. In such cases, all that 
the practitioner has to do is to be assured that the second infant is in 
a proper position, and to take care so to conduct the extraction of the 
after-births that no alarming discharge may follow their expulsion. 

But, when the labour-throes cease, or become trifling on the birth 
of the first infant, the object of the practitioner should be neither to 
interfere before the woman has recruited sufficiently from her 
fatigue, nor to delay extracting the second child so long that the 
passages should become contracted, or the after-birth of the first-born 
be separated. Inattention to this important rule has been the cause 
of the loss of many lives. In more than the majority of cases, do 
more than an hour should be allowed to intervene between the birtii 
of both children. 



43S MANAGEMENT OP FEMALE COMPLAINTS. 

If the delivery be conducted on this simple and obvious principle, 
although in many instances it becomes necessary to alter the posi- 
tion of the second infant, and in that way the woman must be put 
to a little pain, yet all hazard, both to mother and child, may be 
almost certainly avoided. It requires, indeed, considerable attention 
after delivery, to guard against loss of blood, which is a very com- 
mon occurrence, where there had been a plurality of children in the 
womb. 



FALLING DOWN OF THE NAVEL-STRING. 

A portion of the umbilical cord may be forced down, either natu- 
rally or in consequence of mismanagement. In the former case, it 
will be felt through the membranes at the beginning of labour; in the 
latter, it does not come down till after the waters are drained off. 

When the cord is felt originally through the membranes, the pa- 
tient should be kept very quiet, and in one posture, till the circum- 
stances preparatory to delivery are completely accomplished ; when 
the practitioner, by turning the infant, may probably be able to save 
its life. 

But when the early discharge of the water has occasioned the pro- 
trusion of the cord, it is not always in the power of a practitioner to 
obviate the threatening danger without exposing the life of the patient 
to much hazard, which is a risk that ought never to be incurred for 
the precarious chance of saving the infant 



CONVULSIONS DURING LABOUR. 

The precautions by which convulsions, during labour, may, in 
many cases, be prevented, have already been mentioned under the 
head of pregnancy, and the dangers to which pregnant women are 
exposed, when attacked with this frightful disease, have also been 
pointed out. But when it does happen in time of labour, the safety 
of the woman commonly depends on expeditious delivery; and, 
therefore, the proper means for accomplishing so important an object 
must be employed without delay. 

If the mouth of the womb be in any way opened or distended, the 
midwife should introduce the hand in a gradual manner, finger by 
finger, assist the dilatation, and bring the infant into the world. 
Should the convulsions continue after the birth of the child, and the 



MANAGEMENT OF FEMALE COMPLAINTS. 439 

coming away of the after-burden, all that can be done is to keep the 
brain unloaded by topical bleeding, the bowels open by laxative 
medicines, and the irritability of the system counteracted by camphor 
and opium. A large blister may also be applied to the head, and 
small ones to the inside of each leg. 



FLOODING, DURING LABOUR, 

Arises in labour either from an accidental separation of the whole, 
or more commonly from a part of the after- birth, or from the unusual 
place of attachment of that substance. When the discharge is con- 
siderable, there cannot be a question that the patient must be deliv- 
ered either by turning the child or by the forceps, according to the 
stage of labour and situation of the child. 

After the birth of the child, if the natural powers do not separate 
the secundines within an hour, the practitioner should also perform 
that duty. 

When necessity obliges the practitioner to introduce a hand into 
the uterus, the back of the hand should be towards the uterus, and 
the hollow of the hand kept as close to the placenta or after-birth as 
possible in separating it, that the womb may not be injured. 

In some rare cases, the adhesion is so strong that it is impracticable 
to separate the whole of the cake without tearing the womb. The 
portion that is left generally becomes detached in three or four days, 
and its expulsion may be promoted by the use of a stimulating injec- 
tion. Such cases require the most serious attention, lest any putrid 
portion may be absorbed. 

After these stages of labour are safely completed, flooding some- 
times takes place. This is the effect of the womb not having become 
sufficiently contracted, and it requires different management in dif- 
ferent cases. If the discharge be profuse, cloths soaked in cold water 
and vinegar, applied to the naked belly, or even cold water poured 
on the part from a height, should be had recourse to. But some- 
times the flooding is not observable by the attendants, as the blood 
congeals as soon as discharged, and is collected within the womb 
and passages. This circumstance may be feared, if the woman be- 
come sick or faintish, or complain of ringing in her ears, or dimness 
of sight. In such cases, the womb must be forced into contraction 
by manual assistance. 

In all cases of considerable loss of blood, large doses oi' opium, 
frequently repeated, are found of the greatest service iti supporting 
the living powers. (See Immoderate Flow of the Menses — Pro- 
gress of Labour, and Abortion.) 



440 MANAGEMENT OF FEMALE COMPLAINTS. 



MANAGEMENT OF CHILD-BED. 

A child- bed woman, as soon as all the circumstances of her labour 
have been adjusted, may, with propriety, consider herself as still in 
a state of health, and as requiring little more than the common 
cautions, and good management, on all occasions necessary to pre- 
serve it. 

The first hours after the delivery, provided some light nourishment 
have been taken, should be dedicated to quiet and sleep, and no 
person should be allowed to enter the patient's chamber, except such 
as are absolutely necessary. The chamber door, and even the win- 
dows, if the weather be warm, should be opened ; and the room, in 
every respect, kept as clean and as free from any disagreeable smelly 
as any other part of the house. 

The patient should often be supplied with clean linen, well aired ; 
for cleanliness and free pure air, are essential in this situation ; and 
upon the strictest examination, it appears that there never was miliary 
eruption produced without a sweat, nor puerperal fever without foul 
air. The heat of the room ought to be so tempered, that the pa- 
tient may neither be chilled with cold, nor yet suffer from sweat 
or burning. 

The strictest attention should be observed to have an evacuation 
daily by the use, if necessary, of mild laxatives, or by the exhibition 
of clysters composed of milk, oil, and sugar, or of soap-suds. It is a 
security against fever and inflammation, and even forms one princi- 
pal mode of relief when they occur. An equal regard should also 
be paid to get out of the bed, as soon as they can with propriety, and 
to sit up as long as possible without fatiguing themselves. 

If the lochia do not flow so plentifully as may be expected, or if 
they entirely stop, no regard need be paid to this circumstance, if 
the patient be otherwise as well as can be wished. We not only 
find this evacuation different in different women, but even in the 
same women in different lyings-in, from which she recovers equally 
well. 

Much mischief is often done by binding the belly too tightly. If 
there be any occasion for support, a thin napkin pinned very slightly 
round the waist, is all that is absolutely necessary, and the sooner 
this is disused the better. 

But little change takes place in the breasts, after the first months 
of pregnancy, until about the second day after delivery. Then it is 
usual to feel a great sensation of fulness in them, accompanied with 
a febrile irritation, which varies in different women, according to con- 
stitution and management ; but in all is favoured by temperance, a 
cool regimen, and composure of mind. 

The child should always be put to the breast early, before the 
milk can have stagnated in them, or they can have acquired any 



MANAGEMENT OP FEMALE COMPLAINTS. 441 

great degree of hardness. It will be beneficial, both to mother and 
child, if this be done a few hours after delivery ; and this is most 
consistent with the operations of nature. 

If the patient have not nursed any former child, the infant will 
probably meet with difficulties in fastening on the nipples. In this 
case some older infant should be applied, or it will be proper to 
have them drawn by some other means without giving pain. 

Thick rings made of bees- wax, and fitted very exactly to the nip- 
ples, are often preventives of sores, by keeping the nipples elongated. 
They should be applied immediately after the child has finished its 
suction, and be put on so that the ends of the nipples may protrude 
themselves through them. These rings, however, ought not to be 
used when the milk runs out in too great quantities. 

If the woman do not suckle her child, no method should be used 
either to repel the milk, or invite it into the breasts. Nature will 
be certain to do her part. She is soon made sensible, that the blood 
determined to them is not wanted, and there will, therefore, be little 
farther effort made on her part to continue it, and it will in the 
course of a short time cease of itself. A cooling cathartic, with a 
suitable regimen, will entirely supersede the necessity of any local 
treatment, and is all that can be required, even when a mother has 
suckled before. 

No degree of fever in child-bed should be passed over unattended 
to, or be thought lightly of. Even the most serious are often slight 
at their beginning. Neither should any local pain, or tenderness, or 
fulness of the bowels, be neglected, lest they should arise from the 
incipient stage of some inflammation; which, if not checked at first 
by proper medicines or suitable regimen, might, in a short time, put 
on some alarming appearance. Let it be remembered, that it is 
much easier to prevent diseases than to cure them. 

The diet of lying-in women should be particularly attended to. 
All gross meats which might overload the stomach, or, by heating 
the woman, prove a cause of fever, should be strictly prohibited. 
But every patient, after child-bearing, ought not to be half starved, 
as some recommend. Proper regard in this respect should be paid 
to her habit, former manner of living, and present state. Too great 
indulgence, it must be remembered, is more to be dreaded than too 
much abstinence, though both extremes should be equally avoided. 

The bad effects of confined or impure air are now most univer- 
sally knoAvn ; consequently, the propriety and necessity of having 
the bed curtains always open, of preventing many visiters from 
crowding the room, of removing as speedily as possible every thing 
which can contaminate the air, and of admitting occasionally the 
fresh air, by opening the windows and doors, must be obvious. 

Women were formerly obliged to remain in bed for a certain num- 
ber of days after delivery, by which they were much weakened and 
fatigued. In modern times the practice has passed from one ex- 
treme to another. 
56 



4.42 MANAGEMENT OF FEMALE COMPLAINTS. 

This circumstance should surely be regulated according to the 
strength of the patient. When the woman feels that she can easily 
undergo the fatigue of rising, which, in ordinary cases, happens 
about the second, third, or fourth day, she ought to be taken out of 
bed that it may be properly adjusted. If she be made to sit upright, 
she will suffer considerable uneasiness; and, at the same time, by 
the bulky womb, (for that organ does not resume its natural state till 
two or three weeks after delivery,) pressing forcibly on the soft parts 
at the bottom of the basin, the foundation for a very troublesome and 
disagreeable complaint, namely, the falling down of the womb, must 
unavoidably be laid. She ought, therefore, to be placed in a po- 
sition half sitting and half lying, when out of bed, as long as the 
womb continues enlarged, by which means these inconveniences 
will be avoided. 

For the same reason, walking, even from one room to another, at 
least as long as the lochial discharge continues, and the womb is 
bulky, is highly improper. Many women boast that they have been 
able to go through the whole house within a few days after delivery ; 
but they often find, at a subsequent period of life, by the complaints 
which they suffer, that they had little cause to be satisfied with their 
own prudence, or the attention of the practitioner who indulged them 
in such liberties. 



DISEASES OF CHILD-BED. 

As there are certain natural causes of disease during lying-in, so 
there are certain disorders to which women of every description are 
liable, for some time after delivery. 

The most usual complaints which occur in child-bed are as follow ; 
namely : — 

Faintings. — The languid state in which many women are, im- 
mediately after delivery, is sometimes succeeded by faintings. This 
is not dangerous whilst the pulse and breathing continue good, and 
there is no unusual discharge. In this case the complaint may be 
attributed to the peculiar state of the body and mind of the patient 
at that time, and will be readily removed by the exhibition of a little 
wine, toddy, or any cordial. But when the faintings are attended 
with quick irregular pulse and cold extremities, the greatest danger is 
to be apprehended ; for it will generally be found that they are the 
consequences of some violent injury, or of great loss of blood. In 
this alarming case, if there be a considerable discharge from the 
womb, a soft cloth is to be pressed firmly on the external opening, 
and pressure should be made at the same time on the lower part of 
the belly with the hand, to prevent the womb from distending with 



MANAGEMENT OF FEMALE COMPLAINTS. 443 

blood, and to excite its action. A large dose of laudanum or opium 
is also to be administered without delay. And the heat is to be pre- 
served by the application of warm flannels to the stomach, hands and 
feet. 



SHIVERINGS 



Occur from similar causes to f^intings, and sometimes in conse- 
quence of rash and sudden exposure to cold, after being heated with 
the exertion of labour. Nothing, in general, affords more speedy 
relief, than a tea-spoonful of spirits of hartshorn or laudanum in wa- 
ter. At the same time the ordinary means for restoring warmth, by 
the application of heated flannel, as recommended in case of fainting, 
ought to be had recourse to. If it should continue, the camphorated 
mixture, (see Dispensatory,) in doses of a table-spoonful every two 
hours, will be of service. This medicine, given as soon as the child 
is born, commonly prevents both shiverings and faintings in those 
who have been formerly liable to such symptoms. 



AFTER-PAINS. 



For some time after delivery, the contractions of the womb fre- 
quently continue, and occasion pain, which in some cases is so vio- 
lent as to resemble throes of labour. This complaint, termed after- 
pains, though productive of considerable uneasiness, is never to be 
considered dangerous. 

In general, they are most effectually relieved by a full dose of 
laudanum. When the pains continue after the exhibition of this 
medicine, warm flannels, or bladders, two-thirds filled with hot wa- 
ter, should be applied to the lower part of the belly. The campho- 
rated julep, in obstinate cases, will be beneficial, as well as clysters 
to open the bowels, and afterwards an opiate pill, or an injection of 
camomile tea, with two tea-spoons full of laudanum, should be 
administered. 



444 MANAGEMENT OP FEMALE COMPLAINTS. 



LOCHIAL DISCHARGE. 

An increased and sometimes a continual discharge, after delivery, 
is often the consequence of getting up too soon, or making some 
early exertion. When this evacuation continues beyond the ordi- 
nary time, it occasions weakness, and requires the early employ- 
ment of means to prevent the train of nervous disorders, which com- 
monly succeeds a profuse discharge of the menses. With this view, 
tonic medicines, as bark and elixir vitriol, &c, must be employed 
along with nourishing diet, a liberal use of claret wine, and such 
other means as may support the strength. 

The importance of cleanliness, as long as the lochia! discharge 
continues, does not require being pointed out: but when the evacu- 
ation has a bad smell, common attention in that respect is not alone 
sufficient; for unless the most scrupulous regard be paid to prevent 
its stagnation in the passage of the womb, excoriations or inflamma- 
tion, with all their formidable consequences, will ensue. The nurse 
should, therefore, on such occasions, be directed to wash that organ 
by means of a syringe, twice or thrice a-day, with warm milk and 
water, or with an infusion of camomile flowers, or decoction of oak 
bark. 

The lochial discharge is in some women very trifling, and may 
even stop very soon without any bad effect. But when it is sud- 
denly checked by exposure to cold, or other causes, most painful 
consequences may follow, such as swelling of the belly, great pain, 
sickness, and fever. In such cases the evacuation ought to be pro- 
moted by sitting in a tub of warm water, or by the application of 
warm fomentations to the parts, and the exhibition of some gentle 
evacuating medicine, and afterwards endeavour to determine to the 
surface by the use of Dover's powder, with warm diluent drinks. 



MILK-FEVER. 

The breasts are greatly distended for the first two or three days 
after delivery, and in some cases a considerable degree of pain and 
fever are occasioned. The best management in these cases consists 
in gently rubbing the breasts with a little sweet oil morning and 
evening, covering them with flannel, and keeping the bowels open 
with some gentle laxative medicine. 

When the mother's health will not admit of suckling the child, 
she should have her breasts occasionally drawn, and every circum- 
stance which can contribute to the secretion of the milk, should be 



MANAGEMENT OF FEMALE COMPLAINTS, 445 

carefully avoided. Great abstinence should, therefore, be enjoined, 
her body should be kept perfectly open with laxative medicine, and 
as little milk as possible taken. Ripe acid fruits ought to be used, 
which will assuage thirst, and by proving laxative, will assist to carry 
off milk and prevent its secretion. 



LACERATION OF THE PARTS. 

The excessive dilatation sometimes required for the exit of the in- 
fant, and the contraction which follows delivery, occasion a degree 
of soreness and of uneasy feelings that not unfrequently lead the wo- 
man to suppose herself torn. These feelings are removed by bath- 
ing, at first with warm milk and water and afterwards with warm 
spirits. But where the swelling is considerable, attended with 
throbbing pain, emollient poultices ought to be applied, and renewed 
every four hours, until suppuration takes place, and then treated in 
the ordinary way. (See Abscess.) 

Women are sometimes really torn during the birth of the infant ; 
which, in most instances, is the effect of mismanagement. Where 
the laceration is inconsiderable, little more than the ordinary manage- 
ment is required, as the process by which the passages are restored 
to their former state tends to reunite any slight separation of parts. 



INVERSION OF THE WOMB. 

There are two degrees of the inversion of the womb, namely, the 
partial and complete. The former, which is the more ordinary one, 
appears in the shape of a swelling as large as a child's head, pro- 
truded without the passages immediately after expulsion of the after- 
birth, accompanied with violent forcing and bearing-down pains, and 
followed by flooding, faintings, and urgent fruitless attempts to make 
water. This arises from a part, more or less, of that portion of the. 
womb, which had extended, previously to delivery, above the bones 
of the basin, being turned inside out. 

The other degree is so complete an inversion of the womb, that it 
is torn away from its attachments to the sides of the basin, the im- 
mediate consequence of which is instant death. 

Such accidents can only arise from rash and ill-directed endea- 
vours to extract the after-birth, by drawing down the navel-string 
before it can be completely separated. But whatever be the cause, 



446 MANAGEMENT OP FEMALE COMPLAINTS. 

the part must be immediately restored, or the consequence will soon 
prove fatal; for its orifice will contract in its unnatural state, and so 
prevent the needful relief. Therefore, without delay, place the pa- 
tient on her back, with her hips raised, and gently return the uterus 
into the vagina with three fingers, and then with the whole hand 
place it in its natural position; after which, clench the first, and re- 
tain it there until the uterus contract upon it; lastly, apply the ban- 
dages as advised in the case of falling down of the womb, and direct 
the patient to remain in bed some days. 



SEPARATION OF THE SHARE-BONES. 

Is the effect of severe labour or of some former accident, or inflam- 
mation within the joint which connects these bones. This affection 
is distinguished from every other, by the pain being uniformly in- 
creased or excited upon the slightest motion of the lower part of the 
body, and by feeling the share-bones rasp against each other when 
either leg is moved. 

The treatment must depend upon the cause. Where these bones 
have been separated by a blow or fall, at a former period of life, 
they only require being held together by means of a broad belt, till 
the patient have regained strength. The cold bath, whenever it can 
be used with propriety, should be had recourse to, morning and 
evening, as it tends greatly to the accomplishment of that object. 



SWELLED LEG. 

This disease takes place at different periods after delivery, from 
the fourth or fifth day to the seventh week. It is ushered in with 
pain in the back, smart fever, and painful stiffness in the groin. 
Soon after these symptoms, the thigh begins to swell at the upper 
part, and gradually the swelling is extended to the whole limb, so 
that in a short time it is double the size of the sound one. It is 
rather pale-coloured than red ; and is called by some the white leg. 
It is hot, shining, very painful on being touched or moved, and at 
first it does not pit when pressed upon by the finger, and may be 
distinguished by the above marks. 

By active treatment at the beginning of the complaint, its progress 
may be certainly stopped. 



MANAGEMENT OF FEMALE COMPLAINTS. 447 

The bowels should be kept open by salts or cream of tartar, and 
a determination to the skin produced by Dover's powders or some 
of the diaphoretic medicines. (See Dispensatory.) Should these 
not have the desired effect in arresting the disease, a grain or two of 
calomel, given morning and night, until a slight affection of the 
salivary glands are excited, and afterwards the nitric acid, will gene- 
rally succeed. 

Topical applications are also to be employed, as flannels wrung 
out in hot vinegar, and renewed as often as they become cold. 
Good effects have also been derived from the application of a strong 
solution of crude sal-ammoniac and sugar of lead in vinegar. When 
these fail to produce any good effects, surrounding the limb with a 
portion of English bran and sweet oil, with the addition of half an 
ounce of laudanum, or soft-boiled turnips, and renewing it night and 
morning, will afford considerable relief. The best application, how- 
ever, in such cases, when they can be procured, are the leaves of 
the thorn apple, scalded in vinegar ; with which the limb must be 
thickly covered, and then confined by a flannel bandage. 

Friction, with the anodyne or camphorated liniment, has pro- 
duced some good effects, but the mercurial ointment, united with 
camphor, has been externally employed with more permanent 
advantage. 

When the acute symptoms are over, and the limb remains weak, 
friction with the flesh brush is proper, and a roller should be applied 
with moderate firmness from the toe to the groin. The cold -bath is 
useful to re-establish the health. The diet, after the inflammatory 
symptoms have abated, ought to be nourishing; and sleep, when re- 
quired, should be procured by opiates 



INFLAMMATION OF THE BREASTS. 

This disease is easily known by the pain, hardness, and swelling 
which accompany it. In some cases, the whole breast appears to 
be affected, in others, only one side, and in some the affection is 
small and superficial. 

When the breast inflames, it is evident that the retention of the 
milk must, for a time at least, increase the pain. 

The first object then should be to have the breast drawn, either 
by the child or some other means ; but, should the milta not come 
away readily, and the pain be increased thereby, farther attempts 
must not be made; otherwise both the disease and the sufferings of 
the woman may be aggravated. A cooling diet and an open "state 
of the bowels are necessary while the swelling continues. And it 



448 MANAGEMENT OF FEMALE COMPLAINTS. 

is better for the patient to remain in bed, as the weight of the breast, 
while in the erect posture, often increases the inflammation. The 
breast should be gently rubbed with a small quantity of sw T eet oil or 
unsalted butter, and poultices of crumb of bread and lead water ap- 
plied. If the pain and hardness do not very soon go off by this ap- 
plication, warm emollient poultices, as milk and bread, with a little 
oil, or united with the leaves of the thorn apple, must be had re- 
course to. These poultices will not promote suppuration unless the 
inflammation has proceeded so far, that that process has already be- 
gun, and in this case the sooner it is produced the better. 

If the abscess do not point and break soon, no good can be gained 
by delay : an opening should therefore be made, so as to evacuate 
the matter freely. This not only gives immediate relief, but pre- 
vents a farther extension of the mischief. The milk and bread or 
flax-seed poultices must be continued for a few days, in order to re- 
move the hardness, and then the part must be dressed, as in ordinary 
cases. (See Abscess.) 

Indurations remaining after an abscess, may be frequently reme- 
died by the application of a mercurial plaster, or cloths wet with the 
camphorated spirit, or rubbing the part, night and morning, with 
mercurial ointment, united with a little camphor. 

Sometimes after the abscess heals, and the breast seems to be 
cured, it swells a little, especially towards night. This is from weak- 
ness, and is cured by strengthening the constitution. 

In the early stage of this complaint, the best application made by 
the most experienced physicians, is warm vinegar. When the breast 
seems likely to suppurate, the following applications have been made 
with the greatest advantage. Olive oil two ounces. Sugar of lead 
one drachm. Sulphuric ether two drachms. Laudanum one drachm. 

The following has been highly spoken of. Carbonate of lead 
one drachm. Vinegar two ounces. Add spirits of wine one ounce. 
Distilled water, five ounces. To be applied to the breast, cold, with 
a piece of linen. The patient to be restricted to the lightest diet. 
Bowels to be kept open w T ith salts, magnesia, or senna and manna, 
The patient to be made to lie on her back and the breast to be 
lightly covered. Temperature of the air to be moderate and drinks 
cool. 



• SORENESS OF THE NIPPLES. 

The nipples, from the delicacy of their structure, are very liable 
to be injured by the action of the child's mouth in sucking, along 
with the irritation which the stagnant milk occasions, unless they be 



MANAGEMENT OF FEMALE COMPLAINTS. 449 

kept very dry. Women are subject to this complaint more frequently 
while nursing their first or second child than afterwards; for the nip- 
ples lose much of their sensibility by use. 

In the treatment of this disease, the great object to be attended to 
is, to remove, as much as possible, every circumstance which can 
tend to irritate these parts. It is important to keep the nipple dry 
and cool, for which purpose rings of lead are generally worn. The 
nipple ought to be washed frequently with some gentle stimulating 
liquor, as brandy and water, or port wine, or a solution of alum or 
white vitriol, in the proportion of fifteen or twenty grains to four 
ounces of water : these must be frequently varied, for the same lotion 
soon loses its effects. A saturated solution of borax, in vinegar or 
water, with the addition of a little honey, has been very beneficial 
to sore nipples. 

In obstinate cases, the sores should be touched by means of a fine 
hair pencil, with a solution of blue vitriol, or the following liniment, 
which is highly extolled by Dr. Hamilton. Take of litharge and 
vinegar, each, two drachms, olive oil, six drachms, to be made into 
a liniment by rubbing the whole together in a mortar until it be- 
comes of a flesh colour, and the consistence of cream. Washing the 
sore nipples with a decoction of the roots of wild indigo, (see Ma- 
teria Medica,) is also celebrated as a valuable remedy in these 
affections. 

As long as we are under the necessity of applying any medicines 
to the nipples of the mother, it will be prudent not to suffer the child 
to suck her. Where this cannot, however, be dispensed with, the 
part should be well washed with a little warm water, each time, pre- 
viously to giving the child the breast. 

To prevent the sore from being aggravated by sticking to the 
woman's clothes, a little cup made of wax may be laid over the nip- 
ple, which is the part most apt to suffer. If only one nipple be 
affected, the child may be confined to the other ; but if both be af- 
fected, and the pain occasioned by its sucking i& too great to be 
borne, the woman must then desist from the duties of a mother until 
the excoriations are somewnat healed, taking care, however, to have 
the breasts drawn regularly twice or thrice a-day. 

In many cases where the woman has never nursed before, the 
nipples at first are not sufficiently prominent to afford a proper hold 
for the child. In such cases the breasts should be fomented by flan- 
nels dipped in warm water, and then, by gentle pressure on the sides 
of the breasts with the hands, the milk is pushed forward. 

At the same time the pressure is made, the nipple should be 
drawn out by a breast-pipe, and the instant the glass is removed, the 
child being put to the breast, will keep it out by sucking until satis- 
fied. After the operation has been repeated two or three times, the 
child, except in extraordinary cases, will find no difficulty in Bucking. 

Those who have been subject to sore nipples, should endeavour 
to diminish the sensibility of these parts, by applying to them for 
57 



450 MANAGEMENT OF FEMALE COMPLAINTS. 

several weeks previously to delivery, cloths dipped in alum water, in 
strong spirits, or in the pickle of salted meat boiled, which latter has 
been recommended as an infallible specific for that purpose. 

When little sores appear in the brown circle surrounding the nip- 
ple, and correspond with similar appearances in the child's mouth, 
or other parts of the body, there is just cause to suspect some latent 
poison lurks within the system, which, it is more than probable, it 
will require a mercurial course of medicine to subdue. 



INFLAMMATION OF THE WOMB 

Commonly occurs about the second or third day after delivery 
though in some instances later. The existence of it may be ascer- 
tained by pains in the lower part of the belly, which are greatly in- 
creased, by pressure, a constant fever, with a quick hard pulse, and 
a great prostration of strength. The lochial discharge is very early 
suppressed, and the secretion of milk very much diminished. 

It is commonly attended with sickness. It often happens that the 
woman can only lie on her back, and on turning to either side, she 
feels a painful heavy mass fall to that side, and at the same time an 
excessive pain in the loin, kidney, and groin, of the opposite side. 

Many causes tend to induce inflammation of the womb, such as 
abortion, difficult or tedious labour, the exhibition of heating and 
stimulating drinks, exposure to cold after delivery, <fcc. 

As this disease is very rapid in its progress, it calls for the earliest 
attention. Blood-letting is of great importance in the incipient stage, 
and may be repeated in ten or twelve hours if the effect produced 
and the constitution of the patient would justify it. Although strong 
active purges would be highly improper in this disease, yet it is 
necessary to preserve the regular motion of the bowels by giving, 
occasionally, the cathartic mixture or Epsom salts in small doses. 
Emollient and aperient clysters should be frequently administered, 
as they not only unload the intestines, but likewise act as fomenta- 
tions. Medicines which determine to the surface, as Dover's pow- 
der, or diaphoretic drops, with the same mixture, are also highly 
serviceable. 

To remove the tension, and alleviate the pain and soreness, flan- 
nel cloths wrung out in a warm decoction of camomile flowers, or 
any bitter herbs, with the addition of one-fourth of spirits, to which 
a little laudanum may also be added, should be kept pretty con- 
stantly applied to the lower part of the belly, and at bed-time it may 
be rubbed with the camphorated or volatile anodyne liniment. (See 
Dispensatory.) In using fomentations, due care must, however, be 



MANAGEMENT OF FEMALE COMPLAINTS. 451 

taken that they are not applied so wet as to run about the bed, and 
thereby occasion inconvenience to the patient. 

Opiates are necessary to procure rest, but they should not be em- 
ployed until the inflammation has been subdued by blood-letting, 
and aperient and diaphoretic medicines. 

Too much caution cannot be observed by women in guarding 
against any exposure to cold after delivery, as they are thereby apt 
to bring on diseases, which, if they do not prove quickly fatal, not 
unfrequently leave effects behind them, of which they will be sensi- 
ble the whole future period of their lives. 



PERITONEAL INFLAMMATION 

Frequently occurs in women after delivery, and is produced by 
the same causes which give rise to an inflammation of the womb. 

In some cases the inflammation attacks only a small portion of 
the membrane at first, and is afterwards communicated to the whole 
at once. The patient is usually seized with rigors and shiverings, 
thirst, fever and an accelerated pulse, and soon feels considerable 
pain, with soreness, either in a particular part of the abdomen, or 
over the whole of it. The uneasiness and pain increasing rapidly, 
the abdomen becomes puffed up and swelled to a size nearly equal 
to what it was before delivery. From the inflamed state of the parts, 
and the exquisite pain which prevails, the very weight of the bed- 
clothes becomes irksome and insufferable ; and, in order to support 
it, the patient is obliged to lie on her back with her knees bent in 
towards her belly. She is, moreover, incapable of bearing the least 
motion. 

In the cure of this disease, nearly the same mode of treatment 
which had been advised for an inflammation of the womb must be 
adopted. Bleeding from the system to about sixteen or twenty 
ounces should, therefore, be had recourse to at a very early period ; 
particularly where the patient is of a robust plethoric habit, and with 
such it may be necessary to repeat the operation within twelve hours. 

To employ the bowels freely, it will be necessary to employ active 
purgatives from time to time. Fifteen or twenty grains of calomel, 
with four of ipecacuanha, followed by an infusion of senna and 
manna, castor oil, or Epsom salts, will not fail to afford relief by pro- 
moting several evacuations of fetid and dark stools. Should there 
prevail great irritation at the stomach, with frequent vomiting, the 
patient should take, every two or three hours, the saline draught in 
the act of effervescence, with twelve or fifteen drops of laudanum, 
and drink freely of barley water, flax-seed tea, or some mucilaginous 



452 MANAGEMENT OF FEMALE COMPLAINTS. 

drink. In order to determine to the surface, the diaphoretic medi- 
cines should be employed ; and to procure sleep, after the inflam- 
matory symptoms have somewhat subsided, the anodyne sudorific 
bolus or draught may be given at bed-time. To alleviate the pain 
and soreness, fomentations, as advised in inflammation of the womb, 
must be resorted to very early. Emollient clysters should be admin- 
istered during the intervals of employing purgatives, as they will not 
only assist in keeping the bowels open, but will act, likewise, as 
internal fomentations. 

Throughout the whole period of the disorder, the patient is to be 
supported by food of a light, nutritive nature, administered in small 
quantities at a time, and repeated frequently, so as never to overload 
the stomach. 



DELIRIUM, 

Or wandering of the mind, seldom occurs sooner in lying-in 
women than eight or ten days after delivery, and sometimes not for 
a much longer time. It makes its appearance very suddenly, the 
patient not unfrequently awakening terrified from a dream, or all at 
once she breaks out in some absurd or furious conduct. 

There is often very little increase of heat of the skin, or other ap- 
pearance of fever; though in some instances there is considerable 
heat, and the pulse is very quick, and this is especially the case where 
there has just been some strong exertion, or much speaking. But, 
as in all other cases of nervous constitutions, the state of the pulse is 
subject to considerable and sudden variations. 

The patient is usually extremely talkative, and sometimes speaks 
with wonderful volubility. In some cases one idea .seems to possess 
the mind ; and in others the object of apprehension or consideration 
is rapidly varied. She can, however, for a short time be com- 
manded, and at times, at least, appears perfectly sensible of what is 
going on beside her. It is not easy to say what cause produces this 
disease, for it does not appear to be connected with a tendency to 
mental derangement in other circumstances. It is, however, a cu- 
rious and an important fact, that sometimes suckling the infant pro- 
duces melancholy, or other modifications of this complaint. 

When delirium accompanies the milk fever, or the weed, it is 
only a temporary symptom, and ceases upon the original disease 
being removed. When it is the effect of phrensy, the treatment 
consists in those means as advised under the head of inflammation 
of the brain. But, when it appears to be dependent on nervous irri- 
tation, the most successful mode of practice is, shaving and blister- 
ing the head, keeping the bowels open by cooling laxatives, deter 



MANAGEMENT OF FEMALE COMPLAINTS. 453 

mining to the surface by the diaphoretic powders or mixture, and 
afterwards allaying irritation by the camphorated mixture in their 
usual doses. 

If these remedies prove of no avail, the most soothing mild con- 
duct towards the patient ought to be invariably pursued, arid the 
suitable means to promote general good health are to be adopted. 
The woman should be carefully watched, and never left alone. The 
recurrence of this disease, in cases where it has formerly taken place, 
may be prevented by pursuing steadily such measures as shall re- 
move the increased susceptibility of impression which follows delivery, 
and by guarding against all exciting causes. 



MILIARY ERUPTIONS. 



These certainly originate in a child-bed state from improper treat- 
ment ; for whenever a woman in such situation is confined within a 
heated room, oppressed with a great quantity of bed-clothes, and 
forced to drink stimulating liquors, with a view of promoting a 
sweat, according to the absurd and pernicious custom in the treat- 
ment of lying-in patients, she is generally seized with rash fever. 
(See Miliary Fever.) 

To conduct the patient with safety through the disease, we must 
have recourse to some opening medicines, and afterwards restore the 
strength by the use of Peruvian bark, elixir vitriol, and other tonics. 
Where the rash suddenly recedes, it will be necessary to have re- 
course to cordials and diaphoretics. 

Affections of this kind may, in general, be avoided by attention to 
diet, by keeping the patient's bowels in a good state, and by admit- 
ting a proper ventilation through the chamber. 



PUERPERAL FEVER. 



A fever happening from any disease in consequence of pregnancy, 
or delivery of a child, and happening during the time of lying-in, 
may be properly called a child-bed ov puerperal fever. 

The symptoms which characterize the disease are, pain and ten 
sion of the abdomen, short anxious breathing, uncommon quickness 
of the pulse, increased temperature of the body, tensive pain over 
the forehead, peculiar wildness of the eyes, prostration of the vital 
powers, suppression or diminution of the milk and lochia, a flaccid 



454 MANAGEMENT OF FEMALE COMPLAINTS. 

state of the breast, and, upon drawing them, blood instead of milk, 
is frequently discharged. 

The progress of a puerperal fever is sometimes so very rapid, 
particularly in warm climates and hot seasons, as to destroy the 
patient in forty-eight hours. Even in cases seemingly the most fa- 
vourable, we should look on the event as doubtful, as the complaint 
is apt to be accompanied with delusive remissions, and indications 
arise in its progress, which are by no means equal to the danger. 

The causes are various, and sometimes the disorder is inflamma- 
tory, but it soon tends to the putrid kind, and sometimes from the 
beginning a putrid fever. 

During the first stage of puerperal fever, if there be marked in- 
flammatory symptoms, it is advisable to draw some blood from the 
arm, proportioning the quantity to the habit and constitution of the 
patient. The necessity of procuring stools by purgative medicines, 
as well as removing putrid feculent matter, must be obvious, and an 
equal regard should be paid to the state of the skin by administering 
such medicines as determine to the surface of the body, and thereby 
abate febrile heat. With the first intention, the aperient and dia- 
phoretic pills, given in broken doses, or ten or twenty grains of calo- 
mel, with a few grains of ipecacuanha, followed in a few hours after- 
wards by a table-spoonful of Epsom salts, will be found very beneficial 
at the commencement of the disease. And, in order to excite gentle 
perspiration, the spirit of Mindererus, Dover's powders, or diaphoretic 
drops, (see Dispensatory ,) should be employed in their usual doses. 
After these means have produced some good effects, one or two grains 
of opium alone, or conjoined with a few grains of ipecacuanha, or 
the anodyne sudorific draught, may safely be given to relieve pain as 
well as to procure rest. 

It often happens that nausea and vomiting of bilious matter attend 
an attack of this fever. In such cases give a gentle emetic of ipeca- 
cuanha, and after its operation, if the sickness continue, apply to the 
stomach poultices of mint stewed in spirits. 

It has been observed that this fever, after continuing a day or two, 
very often acquires a malignant and putrid tendency. Under such 
circumstances it will be proper to have immediate recourse to the 
remedies advised under the head of nervous fever. 

To alleviate the soreness and distention of the abdomen, we should 
apply fomentations both inwardly and externally ; inwardly, by in- 
jecting emollient clysters from time to time, and externally, by ap- 
plying flannel cloths, wrung out in a warm decoction of camomile 
flowers, or some bitter herbs, with the addition of one-fourth spirits 
and an ounce of laudanum, to one gallon of the decoction, over the 
whole region of the abdomen ; and these ought to be renewed as 
often as they become cold, taking due care that they am not so wet 
as to run about the bed and incommode the patient. 

Where the abdominal cavity is highly painful to the touch, and is 
occupied by extensive inflammation 3 the application of cold to the 



MANAGEMENT OF FEMALE COMPLAINTS. 455 

parts by cloths dipped in a mixture composed of two parts of vinegar 
or cold water, and one of spirits of camphor, has frequently been at- 
tended with happy effects. 

If a gentle purging arise in the first stage, or commencement of the 
complaint, it ought not to be too hastily stopped, as the fever has, in 
some instances, been carried off by such spontaneous evacuation. 



PROTRUSION OF THE VAGINA. 

The vagina, or passage to the womb, is sometimes protruded, or 
pushed out of its natural situation. The disease appears in the form 
of a soft compressible tumour or swelling, protruding without the 
external passage, in some cases extending backwards, and in other 
cases situated on one side. It is not painful when pressed upon, 
and most commonly it subsides when the patient lies down, being 
only troublesome when she is in an erect posture. 

The disease is owing to local relaxation, and that is frequently 
the consequence of mismanagement after lying-in. 

If the prolapsed part be not inflamed, and there is little or no 
swelling, the tumour will be very little trouble. The part may be 
restored with the fingers, which, when done, the patient should rest 
in bed some days, and inject into the vagina, three or four times 
a-day, warm vinegar and water, or port wine and water, or lead 
water, or solution of alum in a decoction of red oak bark or water. 
If the patient be weak, strengthening remedies will be required, as 
the cold bath, bark, rust, or tincture of steel, or tonic powders, or 
pills. At the same time it will be prudent to wear the T bandage. 
When these means fail, it is recommended to make scarifications in 
the descending vagina. 



FALLING DOWN OF THE WOMB. 

This is a much more common complaint than the former, and 
takes place in women of every age, and every rank. As its name 
implies, it consists of change in the situation of the womb, by which 
that organ lies much lower than it ought to do. In some cases ii 
absolutely protrudes entirely without the parts. The slightest degrees 
are styled bearing down; and the more violent ones descent or falling 
-down of the womb. 



456 MANAGEMENT OF FEMALE COMPLAINTS. 

In general, the first symptom of this complaint is an uneasy sen- 
sation in the lower part of the back while standing or walking, with 
now and then a kind of pressure and bearing down. 

If these feelings be disregarded, the complaint increases, and the 
patient becomes incapable of making water without first lying down, 
or pushing up a swelling which seems to stop the discharge of urine; 
and if the disease continue to increase, the womb is actually forced 
out of the parts, and takes on the form of a bulky substance hanging 
down between the thighs. This extreme degree of the complaint 
can seldom happen, excepting in women who have had a great many 
children, but the less degrees of it occur occasionally in very young 
unmarried women. 

The causes of descent of the womb ought to be known to every 
woman, as many of them may be avoided. Every disease which 
induces weakness of the habit in general, or of the passage leading 
to the womb, in particular, must lay the foundation for the complaint. 
Frequent miscarriages, improper treatment during labour, too early 
or violent exercise after delivery, are in married women, the most 
frequent circumstances by which falling down of the womb is pro- 
duced. In the unmarried, it is apt to take place in consequence of 
violent exercise, as in dancing, riding, &c, while out of order, a fact 
that ought to be impressed on the mind of every young woman. 

In the treatment of this complaint, the means must be adapted to 
the degree of its violence. When the descent is inconsiderable, and 
the case is of recent date, the daily use of the cold bath, invigorating 
diet, very moderate exercise, and the injection of any mild astringent 
liquor into the passage, evening and morning, will probably prove 
successful. But should the disease be in a great degree of long 
standing, a course of tonics, with the frequent use of astringent in- 
jections, as a strong solution of alum in water, or decoction of red 
oak bark, must be added to the above means. 

Dr. Leak advises, that after the parts are reduced, the intention 
of contracting the relaxed vagina so as to prevent its future descent, 
may be effected by the frequent use of the following astringent in- 
jection. Take of alum, and white vitriol, each, one drachm, boil- 
ing water one pound, mix and filter through paper. Inject it into 
the vagina, milk warm, with a womb syringe. At the same time 
endeavour to strengthen the whole bodily system by nourishing diet, 
and tonic medicines. 

When the complaint resists such remedies, or when, from its de- 
gree, it may appear unnecessary to employ them, the only relief 
which can be afforded, unless the womb become pregnant, is to be 
obtained by wearing an instrument called a pessary. It is made of 
wood or ivory, and if properly adapted to the passage, and of a pro- 
per construction, it can be worn without much inconvenience, and 
it never occasions pain. Certain attentions, are however necessary, 
whenever such an instrument is used. Thus, the pessaiy should 
never be allowed to remain in the passage above a few days at a 



MANAGEMENT OF FEMALE COMPLAINTS. 457 

time, otherwise it becomes the source of great irritation. It should, 
therefore, be occasionally withdrawn on going to bed, well cleaned 
and re-introduced in the morning, before the patient rises. In some 
instances, after a pessary of a certain size has been worn for several 
months, one of a smaller size becomes better adapted to the passages, 
and in other cases one of a larger size is required. 

Sponges of such a size as, when expanded, fill up the cavity of 
the vagina, are very good pessaries. They support the uterus, and, 
by putting a string through them, the end of which is to be left 
hanging out of the os externum, the woman can take them away 
and apply them herself very conveniently. 

To answer this purpose, a fine sponge, wrung out in alum water, 
may be dried in a compressed state, and cut into any convenient 
form, so as to be introduced as high as possible : this will act by its 
astringency, and by its pressure, in a gentle and uniform manner. 
During the use of this application, an astringent injection may be 
used twice a-day ; and the sponge tent should be made gradually 
smaller as the vagina contracts. 

The application of the bandage round the whole belly, with a 
moderate degree of firmness, often gives great relief to the uneasy 
feelings. The T bandage has also been worn in this case with con- 
siderable advantage. 

If a woman, liable to falling down of the womb, become preg- 
nant, there is no occasion for the pessary after the third month, and 
by proper treatment after delivery, the return of the complaint may 
be prevented. 

In the Edinburgh " Medical Commentaries " is the following ac- 
count. A woman of singular fortitude, about fifty years of age, was 
much afflicted with prolapsus uteri. After trying many remedies in 
vain, and being tired out with the continuance of the complaint, she 
at length cut into the substance of the womb with a common kitchen 
knife. A considerable hemorrhage ensued ; after which, the uterus 
gradually contracted, and she had neither a return of the prolapsus, 
nor was she afflicted with any other symptoms. Having boasted of 
her success, many women in the neighbourhood, afflicted with the 
same complaint, applied for her assistance, and by a similar opera- 
tion were effectually cured. 

It is supposed that scarifications may succeed instead of incisions 
of the prolapsed womb, and the same method of cure is still more 
strongly recommended in the protrusion of the vagina. 

We can recommend with great confidence, in cases of this sort, 
the " abdominal supporter" of Mr. Betts, which is so made as to hue 
up in front, behind, and at the sides. This admirable instrument 
takes off all pressure of the superincumbent organs in a debilitated 
and crippled state from long and tedious disease. A lady to whom 
we very recently had it applied, rose from her bed the same day, to 
which she had been long confined, and walked nearly one mile and 
back, a degree of exercise to which she had been a stranger more 
58 



458 MANAGEMENT OF FEMALE COMPLAINTS. 

than a twelvemonth. In another case, attended with a tedious 
hemorrhage, all the usual remedies failed till the application of this 
instrument proved of signal advantage. She was soon entirely 
restored. 



POLYPUS IN THE WOMB. 

The vagina and womb are subject to fleshy excrescences, called 
Polypus Tumours, in common with some other parts of the body. 
These, in many cases, are soft as clotted blood ; in others they 
resemble flesh ; and sometimes they are found of a hard consistence. 
They are of different sizes and shapes. 

The mild polypus is connected to the womb generally by a nar- 
row neck. As it grows the womb enlarges ; and presently its mouth 
dilates, so that the polypus can be felt with the finger. Then it 
gradually descends into the passage, or, in some instances, is forced 
down, with pains like those of labour. 

Excrescences of the womb differ from descent of that organ, in 
being attended with the frequent discharges of blood, and when felt, 
in being broad and bulky, and having no orifice like the protruded 
womb, and in being easily moved or twirled around, as it were by 
the finger. 

The cause of this complaint has not been ascertained. It is evi- 
dently unconnected with the married state, as it occurs in unmarried 
women ; and it does not appear to attack, exclusively, any particular 
constitution. 

No medicines have any power over this tumour, but it may be 
safely and successfully removed, by the application of a ligature 
round its neck. This operation gives no pain, and is practicable, 
whenever the mouth of the womb has dilated completely. But, if 
the symptoms be not urgent, it will be better to delay, until the 
polypus have wholly, or in part, descended into the passage, as the 
ligature can then be still more easily and successfully applied. 

There is a tumour of a different kind, met with in the womb, 
which does not spring from the surface of its cavity, but is imbedded 
in its substance. It forms a knob or projection, which gradually in- 
creases ; and, in some instances, several of these form in succession, 
and the womb becomes considerably enlarged. 

This tumour is called a tubercle. It produces very nearly the 
same symptoms with polypus. The distinction between this disease 
and a polypus, can only be made by a skilful examination, which 
determines the point. 

The growth may very frequently be checked, and in several 
cases its size may be even greatly diminished, by taking, for a length 



MANAGEMENT OF FEMALE COMPLAINTS. 459 

of time, two or three drachms of the vitriolated tartar, or cream of 
tartar, in a glass of water eveiy morning before breakfast. Should 
this not be sufficient to keep the bowels in rather a laxative state, 
its operation may be assisted by taking, at bed-time, an aloetic pill. 
Much advantage is also derived by the use of the warm sea bath, 
which, if not attainable, a little salt added to the water may be sub- 
stituted. The patient must observe a light diet, and carefully avoid 
heating and stimulating drinks. Perhaps a mercurial course might 
be attended with good effects in this affection of the womb, and 
afterwards the nitric acid. 

The possibility of removing this complaint, or of keeping it in 
subjection by proper remedies, and the great probability of completely 
curing a polypus, by a simple operation, or of relieving by a me- 
chanical contrivance, a bearing down of the womb must be surely 
powerful inducements for women labouring under symptoms of these 
complaints, to submit early to skilful examination, which can alone 
determine the precise nature of their disease. 



CANCER OF THE WOMB. 



This disease most frequently appears about the time when the 
menstrual evacuation ceases, but no age is exempted from it. 

Its approach is, in general, gradual. At first the patient feels an 
uneasy weight in the lower part of the belly, with the sensation of 
heat or disagreeable itching. By degrees irregular shooting pains, 
darting across from the share bones, take place. The pain at last 
becomes fixed in the womb, and is described to occasion a constant 
gnawing, burning sensation. A discharge of ill-coloured, fetid, acrid 
matter from the vagina, attends this pain; and, notwithstanding 
every attention to cleanliness, excoriates the neighbouring parts. 

The nature of cancer is not yet properly understood by practi- 
tioners; but it is well known, that the first change in the part which 
afterwards becomes cancerous, is a thickening and hardening of its 
substance. This may be suspected to have taken place in the womb, 
if there be pains in the thighs and back, bearing down when using 
exercise, and occasional violent discharge of clotted blood. By early 
attention to such symptoms, many individuals have had the progress 
of the disease completely arrested. 

In the early stages of cancer of the womb, a continued perseverance 
in milk and vegetable diet, a total abstinence from animal food of 
all kinds, and every fermented liquor, and occasional blood-letting, 
and in some cases the establishment of one or two issues in the arms 
or above the knees, together with frequent doses of cooling laxative 



460 MANAGEMENT OF FEMALE COMPLAINTS. 

salts, tends most materially to relieve the symptoms, and to retard 
the progress of the disease. 

Pain and irritation, which strongly tend to increase, are allayed 
by the use, every night, of the warm bath, impregnated with salt. 
This sooths the part, and indeed the whole system, and contributes 
materially to the relief of the patient. The injection of decoction 
of camomile flowers into the passage, morning and evening, is always 
proper. Discharges of blood are moderated by rest, keeping the 
patient cool, and pressing a cloth firmly on the passage. Should 
the size of the tumour render the passage of the stools or urine diffi- 
cult, it will be necessary to assist the 'evacuation of the former by 
laxatives, and to have the latter regularly drawn off. Care must be 
taken, however, to give no stronger laxative than is sufficient to 
produce the desired effect; for frequent stools, in such circumstances, 
give great fatigue and produce much injury. 

Should there be, in the last stage, much pain or restlessness, these 
must be overcome by opiates. The fetid discharge is to be carefully 
washed away, and every attention must be paid to the mitigation of 
those evils and distresses connected with protracted disease. 

A variety of medicines have been proposed for the cure of cancer 
in every part of the body. These are generally useless, and some- 
times hurtful. The pretensions of empirics, and the no less injurious 
interference of friends and acquaintances, who have all their own 
mode of cure, too often deceive the patient, and prevent her from 
using those simple but salutary means, which at first keep the disease 
in subjection; or from submitting to an operation when the complaint 
is seated in a part capable of being removed. The only time when 
benefit can be derived is thus lost, and nothing afterwards remains 
but to diminish as much as possible, the misery of the patient. 



A MOLE, 

Is a fleshy or bloody substance contained in the womb, and its 
size varies from that of a nut to an orange, or it may even become 
larger. The symptoms are very much the same at first with those 
of pregnancy, so that this has been called a false conception. How- 
ever in pregnancy the belly often becomes flat and less, until the end 
of the second month; on the contrary, when there is a mole, the 
belly increases from the first, and so continues to the second or third 
month, at which time it generally comes away. If it continues lon- 
ger, it often proves troublesome by the flooding it occasions. After 
the period of four months, the mole excites no motion in the womb 
like those of a living child : it distends the belly equally, and changes 



MANAGEMENT OF FEMALE COMPLAINTS. 461 

its situation according to the posture of the mother, which is never 
known to happen whilst the foetus is alive. 

It is produced by the retention of a clot of blood in the womb after 
a miscarriage, a profuse menstruation, or it may follow a delivery at 
the full time, or may be occasioned by the retention of a blighted 
conception. 

When a mole occasions no ill symptoms in the mother, no violence 
should be used to bring it away, but* it may continue many years 
without creating any remarkable inconvenience. If it comes away 
by the end of the third month, it rarely happens that any assistance 
is necessary. Let the finger be gradually introduced into the womb, 
and if that suffice not, introduce another, and thus the mole will 
generally be excluded by the pain which attends on these occasions. 
The mole is expelled with the same symptoms as in a miscarriage, 
and requires similar management. 

A substance of a different nature is occasionally met with ; namely, 
a mass consisting of small bladders, called hydatids. These blad- 
ders, which contain water, may be very numerous, and somewhat 
resemble a thick cluster of grapes. Some of them are not larger 
than the head of a pin, others larger than a nut, or one or two may 
even acquire a greater size. Generally speaking, they are produced 
by the same causes which occasion a mole; but they usually proceed 
from the retention of a blighted conception, which comes to be con- 
verted into hydatids. In this last case, the time when the embryo 
or foetus perishes, is marked by the breast becoming flaccid, and the 
morning thickness going off. The belly does not increase in size, or 
if it do, it is slowly. The patient does not become regular, as she 
would have done, had the womb been emptied; but she may be 
subject to irregular discharges of blood. At length, after an uncer- 
tain period, pains like those of labour come on, and the mass is ex- 
pelled, often with a very considerable flooding. The management 
is the same as in an abortion. After the expulsion, milk sometimes 
appears in the breasts. 



DROPSY OF THE OVARIUM. 

The appendages of the womb called Ovaries, are frequently the 
seat of dropsy. This disease occurs at every period of life. 

It is a most extraordinary fact, that a small body, not larger than 
a nutmeg, and having naturally no cavity, should by disease become 
so enlarged as to contain, iu many instances, above ten gallons of 
watery fluid. 

At first, dropsy of the ovarium is very considerable, and attended 
with no disagreeable symptoms. It increases gradually in bulk, 



462 MANAGEMENT OF FEMALE COMPLAINTS. 

and is originally confined to one side only, more frequently the left 
one. The patient enjoys usual good health, in most cases, till the 
tumour has acquired a considerable size ; it then induces pain and 
numbness in the thigh corresponding with the side in which the 
swelling is situated, and by degrees the body becomes wasted, the 
appetite bad, and the strength impaired. 

Nothing can be more uncertain than the progress or termination 
of this complaint. Experience has proved, that, under the most 
apparently desperate circumstances, the health has been in a man- 
ner restored, or life for a considerable time protracted ; while, on the 
other hand, where no urgent symptoms have appeared, a sudden 
aggravation of complaints has occurred, and a rapid advance to the 
fatal termination has takan place. 

With respect to the cause of this disease, nothing satisfactory can 
be offered. Women of every age and condition are found afflicted 
with it. Human prudence, there is reason to fear, can neither fore- 
see nor prevent its occurrence. 

This disease can be very rarely cured. Our chief and most 
rational object is to keep it from increasing quickly. For this pur- 
pose diuretics have been tried, but they have no effect. The best 
practice seems to be, to make gentle pressure externally with a ban- 
dage, so as to support the parts, at the same time, that we may keep 
the bowels open, and use means for invigorating the constitution. 
Troublesome symptoms must be palliated by appropriate remedies. 

When the tumour has acquired a great size, and produces breath- 
lessness and other urgent symptoms, the water may be taken off by 
the operation of tapping. A temporary relief, however, will only be 
obtained by these means, for the fluid is commonly soon again accu- 
mulated in increased quantity. 

In some rare cases, where the general health of the patient re- 
mains unimpaired, by the use of strengthening remedies, the disease 
has been prevented from returning after tapping ; and hence patients, 
under such circumstances, should not altogether despair. 

Dr. Cutbush gives an instance of a dropsy of the Fallopian tubes, 
being effectually cured by the application of tobacco. (See Materia 
Medica.) 



WORMS. 

Women after childbirth, are very frequently much troubled with 
worms, particularly the small white worms called ascarides. These 
produce a very troublesome itching about the fundament or lower 
part of the intestine. They also occasion want of appetite, or de- 
praved appetite, itching in the nose, pale face, irregular pains in the 



MANAGEMENT OF FEMALE COMPLAINTS. 463 

belly or sides, and sometimes a difficulty in making water. If the 
stools are examined, they may often be found mixed with slime, and 
worms can be discovered like small pieces of white thread. 

The most effectual means of destroying these animals, is, to use 
morning and night, as long as the symptoms continue, a clyster, 
composed of two drachms of aloes rubbed up with a pint of muci- 
lage of gum Arabic, slippery elm, or flax-seed, or thin gruel. If this 
should not answer, injections of half an ounce or more of the oil or 
spirits of turpentine, mixed well with the mucilage, or gruel, should 
be repeated twice or thrice a-week. 

A different kind of worm is found higher up, having, to a super- 
ficial observer, much the appearance of the common earth worm, 
whilst another species, namely, the tape worm, is flat and jointed. 
These produce, generally, more pain in the belly than ascarides, and 
seldom any itching about the extremity of the bowels. 

The treatment is twofold, first to give calomel at bed-time, fol- 
lowed by brisk purgatives the next morning, which not only forces 
the worms away, but by removing much of the slime of the bowels, 
destroys their favourite and necessary habitation. 

The second part of the treatment consists in giving such medicines 
as are supposed to kill the worms, such as the filings of tin or iron, 
or Carolina pink root, or pride of China. (See Materia Medica.) 

For the destruction of the tape worm, the oil of turpentine is con- 
sidered very efficacious, as also the male-fern root. The dose of the 
former, is from a half to an ounce given in milk, mucilage, or thin 
gruel. The dose of the latter, is from one to two drachms, which 
may be taken in the morning on an empty stomach, for two or three 
successive days, and the following morning after the last dose, take 
a dose of calomel and rhubarb, jalap or castor oil. 

As an auxiliary remedy in cure of worms, considerable benefit is 
sometimes derived by applying, externally, over the region of the 
belly and stomach, a cataplasm made of the leaves of tobacco 
pounded and wetted in vinegar, or one of ox gall formed of a due 
consistence with corn or oat meal. 

These remedies have been known to succeed after powerful ver- 
mifuge medicines, internally administered, have failed to produce 
any good effect. 

An hereditary predisposition to have worms formed in the bowels 
and stomach, seems to exist in some persons, as all the children of 
one family have been known to be troubled with them. 



464 MANAGEMENT OF FEMALE COMPLAINTS. 



BARRENNESS. 

Sterility is a misfortune few women become altogether reconciled 
to. In various countries and in different ages of the world, charms 
and spells, and powerful elixirs, have been resorted to ; rich offer- 
ings have been presented at the shrine of a favourite saint; pil- 
grimages have been undertaken to holy wells ; and, in addition to 
all, the virtues of potent herbs and drugs have been made trial of, 
for the removal of this infirmity. When we consult the writings of 
the old physicians on this subject, we find numerous recipes, con- 
taining medicines sometimes of opposite qualities, and sometimes no 
quality at all. The practice of the moderns is, at least, more simple, 
if not more efficacious. Sterility proceeds from either a temporary 
or permanent incapability of conceiving or retaining the embryo, till 
it acquires a form. The causes producing this incapability, may 
consist in some malformation or deficiency of the womb, or its ap- 
pendages, which cannot always be discovered during life, or in 
merely a weakness in the action of the womb. This last is by far 
the most frequent cause, and it is occasioned by local weakness of 
the womb, or general affections of the whole system ; and is marked 
usually by an obstruction, deficiency, or redundancy of the men- 
strual evacuation, or by the complaint termed female weakness. It 
is very rare, indeed, for a woman to be barren, who is, in all respects, 
regular. 

We do not, in the present age, pretend to the knowledge of any 
elixir or medicine, which has the specific power of curing sterility. 
We proceed on the principle of rectifying the constitution, where it 
is injured or weak, and of restoring the menstrual evacuation, to its 
due and healthy state. The means for effecting these purposes, 
must depend on the situation of the individual, and may be learned 
from some of the preceding chapters of this work. 

There are chiefly two states of the constitution productive of those 
deviations in the action of the womb, which cause barrenness. The 
first is a state of fulness, and a disposition to obesity. 

The person gradually becomes fat and inactive, the menstrual 
evacuation continues regular for some time ; but at last diminishes, 
and becomes obstructed, or goes to the opposite extreme, and be- 
comes frequent or profuse. The patient is either barren or subject 
to false conceptions and abortion. This state is to be rectified by 
spare or vegetable diet, total abstinence from malt liquor, regular and 
constant exercise, especially early in the mornings and on horseback, 
the prudent use of laxatives, and after some time the cold bath. 
These means will, if persisted in prudently, effect the desired 
changes ; but if pushed to an undue degree, and especially if re- 
peated purgatives, and much vinegar, or great abstinence be resorted 
to, the health may be completely ruined. 



MANAGEMENT OF FEMALE COMPLAINTS. 465 

The second state is that of relaxation, the habit is spare, instead 
of corpulent; the mind is lively, and, perhaps, even irritable; the 
menstrual evacuation either profuse, or it recurs too frequently, and 
at times clots and shreds are discharged. 

This requires a different treatment; the diet, if not unusually 
nutritive, is at least not to be sparing, the exercise must not be car- 
ried the length of fatigue, the cold bath is useful, and strengthening 
medicines are required. 

Such remedies as have been pointed out for the removal of irre- 
gularities of the menstrual evacuations, or of fluor albus, must be 
employed when necessary. 

By persisting carefully in a proper plan, sterility may at length be 
frequently removed. There are many instances of women bearing 
children, after having been several years barren. 

This doubtless often — indeed very generally arises from defective 
menstruation. 

We can point to several instances of ladies in whom, great im- 
provement in this respect took place and impregnation was the con- 
sequence. Perhaps nothing would prove of more service than that 
renovation of the constitution which usually follows the sickness 
produced by a sea- voyage, and a short residence in a different cli- 
mate. At any rate we can point to several cases where this seemed 
to have been attended with the desired effect. 

Sterility may arise from leucorrhoea, and here those remedies 
should be resorted to which yield the most success in these chronic 
discharges, such as cutaneous revulsions — baths — douches — dry fric- 
tions over the body, added to the use of woollen or flannel shirts. 
Blisters and issues about the lumbar region have been beneficial. 

Amenorrhcea and menorrhagia are also causes of sterility. The 
treatment must be varied according to the numerous causes which 
produce them. 



59 



MANAGEMENT 



AND 



DISEASES OE CHILDREN. 



After the child is born, the first thing to be done, if it be lively, 
is to separate it from the mother. But. if it do not cry or manifest 
signs of life, this is to be done with greater hesitation. Children do 
not breathe in the womb, but have that function compensated for, 
by the circulation of the blood, through the after-birth, by means of 
the navel-string. Now, if after being born, the child do not breathe, 
gasp, or cry, then, after ascertaining that the face and mouth are not 
covered with the membranes, and that the naval-string is not in- 
circled round the throat so as to prevent breathing, the next thing 
for consideration is, whether it is still deriving any assistance from 
the after-birth; for if so, removing the child would be a fatal step. 
This we know, by taking the navel-string between the fingers and 
thumbs; if a beating or pulsation be felt, the circulation is going on, 
and, as long as that continues, the cord ought not to be tied. There 
may be exceptions to this general rule ; but of these exceptions, nurses 
and attendants cannot judge, and, therefore, to them, the rule is ab- 
solute. The child is to be kept warm below the clothes, except the 
face, and is to be rubbed with the hand, particularly over the breast. 
If it begin to breathe soon, and give one or two convulsive struggles, 
there is seldom any risk; it will speedily cry aloud, and may then 
be separated. But, if it do not breathe, and the pulsations in the 
cord stop, then, after this, no good can accrue from letting the child 
remain in that situation ; the cord is to be tied and cut ; or, if the 
pulsation stop immediately after the birth of the child, it is not to be 
continued connected to the mother. In either case, whether there 
never was pulsation discernible, or whether there was at first pulsa- 
tion, but that have now ceased, the child is to be immediately re- 
moved, and measures used for restoring animation, unless there be 
evidence from the putrid appearance of the child, or cord, that it 
has been long dead. 



MANAGEMENT OF CHILDREN. 467 

Still-Born. — Children may be still-born, in consequence of va- 
rious causes, such as pressure on the navel-string, during labour, so 
as to obstruct the circulation ; long continued labour after the waters 
are drained off; or from remaining long with the head pressed in 
the bones of the mother; besides other causes connected with the 
state of the child itself, inducing actual death before delivery, or 
unfitting it for breathing after birth. 

The occasional recovery of still-born children under circumstances 
where experience alone could have encouraged such hopes, ought to 
teach practitioners of midwifery the importance of employing, with 
patience and attention, the means conducive to this purpose. 

These means consist chiefly in preserving the heat, and endea- 
vouring to produce respirations. The first is done by immersing 
the child up to the neck in lukewarm water, or covering it with 
warm flannel until that can be procured. The second is effected by 
such means as tend to rouse the system in general, such as friction 
with spirits over the body, the application of some stimulant to the 
face, such as touching the temples, nostrils, and lips, with a feather 
dipped in vitriolic ether, or spirits of hartshorn, slapping the buttock 
and soles of the feet, with the palm of the hand, and giving an in- 
jection consisting of a tea-spoonful of spirits with two or three table- 
spoonsful of warm water, or a little salt and water, but chiefly by 
endeavouring directly to excite the functions of respiration, by infla- 
ting the lungs with air. This is done by means of a bag of elastic 
gum, or a common syringe, the pipe of which is to be inserted into 
one nostril, while the other and the mouth are carefully closed ; and 
are then, by gentle pressure on the breast, to be emptied. In this 
way the lungs are to be alternately distended and compressed for 
some time. Should the process of breathing commence after these 
means have been used for a few minutes, nothing else is to be 
done than keeping fthe infant warm, with its face freely exposed 
to the air. 

Fortunately the above means for recovering still-born infants are 
seldom required, and the child, in a few seconds after birth, cries 
and breathes freely. 

Navel Cord. — In general there is more impatience shown by 
the attendants than is prudent, in respect to tying the navel-string. 
In order to tie the cord as it ought to be, two ligatures will be neces- 
sary, which should be formed of such a number of threads, knotted 
together at each end, that in tying firmly with them, there may be 
no danger of dividing the navel-string. And as soon as the circula- 
tion in the umbilical cord is stopped, one of them is to be applied 
about three or four fingers' breadth from the navel, and the other 
about two inches from the first, on that side next the placenta, and 
then divide the cord between them. 

On separating the child from the parent, the first thing to be done, 
is cautiously to wash off the white crust which covers the skin bv 
means of a little soap and lukewarm water. The child being 



46S MANAGEMENT OF CHILDREN. 

cleansed, a small bit of soft rag is next wrapt round the navel-string, 
and a band is wound lightly round the belly. After this the child 
is to be dressed suitably to the season. 

The portion of cord which is left next the belly, drops off within 
five or six days after birth, and leaves a tenderness that is generally 
entirely removed in two or three weeks, by the ^rdinary means 
which nurses employ. A split raisin applied every morning under- 
neath the singed rag, accelerates greatly this process. — When a 
complete separation of the cord does not take place in a week, it is 
usually found to hang only by a very small filament or thread, which 
should be divided. 

Clothing. — Midwifery was first practised by women. Hence 
the dressing of children became an art which few could attain. Each 
midwife strove to outdo all others in this pretended knowledge. 
These attempts were seconded by the vanity of parents, who, too 
often desirous of making a show of the infant as soon as it was bom, 
were ambitious to have as much finery heaped upon it as possible. 
Thus it came to be thought as necessary for a midwife to excel in 
bracing and dressing an infant, as for a surgeon to be expert in ap- 
plying bandages to a broken limb ; and the poor child, as soon as 
it came into the world, had as many rollers and wrappers applied 
to the throat and body, as if every bone had been fractured in the 
birth ; and these often so tight, as not only to gall and wound its 
tender frame, but even to obstruct the motion of the organs necssary 
for life. 

The clothing of infants should be light and simple, and made 
to tie with tape, as pins are dangerous. Almost every child cries 
on being dressed, and, therefore, it is desirable to have the dress 
constructed in such a manner, that it may be easily and readily 
applied. . 

If it be wished to have them strong upon their limbs, and active, 
early in life, as by nature they are intended to be, they should have 
the perfect freedom of their limbs, and their bodies easy, from the 
first day of their birth. — Their clothes should, therefore, be reasonably 
loose upon them, and not too great in quantity, although properly 
proportioned to the nature and variableness of the weather. 

The quantity of an infant's bed covering should also be appropri- 
ate to the season of the year. The night-clothes must not be equal 
in quantity to those which are worn during the day ; otherwise a 
great tendency to be affected with colds, &c, may be induced. For 
the same reason, when the infant sleeps in his day-clothes, he should 
be very slightly covered. 

Infants sleep much at first, and ought not to be disturbed ; in this 
respect, they may be left to their own propensity, and as they grow 
older, they sleep less. The only point to be attended to, when they 
become so old as to have the sleep regulated, is to prevent their 
sleeping so much through the day, as would make them restless 
at night. 



MANAGEMENT OF CHILDREN. 469 

Purging. — The practice of giving infants, as soon as born, butter 
and sugar, mixed, salt and water, or purging medicines, has often 
proved detrimental by promoting acidity in the bowels. If the in- 
fant, after being completely dressed, be apparently quite easy, it 
should be laid down to sleep, without taking any thing ; and after a 
few hours it may be applied to the mother's breast, whose milk, at 
that period being laxative, answers the purpose of cleansing better 
than all the drugs in the apothecary's shop ; and by putting the child 
early to the breast, especially the first time of suckling, the nipple 
will be formed, and the milk gradually brought on. Hence much 
pain, and its consequences, will be prevented. To teach the child 
how to suck, a little milk and water, sweetened with white sugar, 
may be given at the end of a tea-spoon, which the innocent will 
clasp in its mouth ; or a finger wetted with it may be frequently put 
between the gums. 

In cases where the infant appears to be loaded with phlegm, a 
little well made plain grit gruel should be given immediately, and 
when this or its natural food, the milk, is not found sufficient to ex- 
pel the meconium, or first black stools, a solution of manna, or a 
tea-spoonful of good castor oil, may with propriety be given. 

Nutriton. — It is too much the practice to give children food or 
drink before putting them to the breast, on the principle of support- 
ing them until the milk come. — Infants do not suffer so much from 
want of nourishment immediately after birth, as they do when de- 
prived of the breast for the same number of hours, after they have 
once sucked. The young of no other animal requires to be fed be- 
fore sucking the mother; and if infants be applied early to the breast, 
they will not require it either. No food is so proper for the child, as 
the mother's milk; and where she has plenty, and the milk agrees 
with the infant, it ought to constitute the sole support for several 
weeks. 

" Doubt ye the laws by nature's God ordained 1 
Or that the callow young should be sustained 
Upon the parent breast ? Be those your schools 
Where nature triumphs and where instinct rules." 

After the second or third month, it may then be proper to give the 
child once or twice a-day, a little of some other food. This will 
ease the mother, will accustom the child by degrees to take food, and 
will render weaning both less difficult, and less dangerous. Nature 
abhors all sudden transitions. For this purpose the food of children 
ought not only to be simple, but to resemble, nearly as possible, the 
properties of milk. Indeed, milk should make a principal part of 
their food, not only before they are weaned, but for a long time after. 

Infants generally suck greedily, and, if allowed, would gorge 
themselves, and injure their stomach. The mother, therefore, ought 
not to become the slave of the child, and, especially, ought not to 
allow it to sleep at the breast. — Children may early be taught to suck 



470 MANAGEMENT OF CHILDREN. 

at regular intervals, and never should be indulged as often through 
the night as through the day ; which breaks the mother's rest, is apt 
to hurt her health, and generally injures her as a nurse. One 
suck late at night, and another early in the morning, will be quite 
sufficient. 

It has been improperly imagined, that all mothers ought to be 
nurses. By this opinion many children have been destroyed, and a 
greater number have only lived to regret their existence ; the weak- 
ness of their frames having made them strangers to the comforts of 
good health. 

Whenever the parent is injured by giving suck, or the child is 
stinted in nourishment, or hurt by the quality of the milk, it becomes 
a positive duty to procure a healthy nurse. 

" Think not that I would bid your softness share 
Undue fatigue, and every grosser care ; 
Another's toils may here supply your own, 
But be the task of nurture yours alone." 

When the infant cannot obtain the milk of the mother, or that of 
a healthy woman who laid in about the same time, the best food, for 
several weeks, at least, is new milk alone, or mixed with an equal 
quantity of arrow root, or well boiled grit or barley gruel, with the 
addition of a little sugar. As the child advances in age, and its 
strength increases, weak broths, with a little barley, rice, or hard 
biscuit, boiled in them, may be allowed. It is soon enough to allow 
children animal food, when they have got teeth to tear it. 

Bread may be given to a child as soon as it shows an inclination 
to chew. The very chewing of bread will promote the cutting of 
the teeth, and the discharge of saliva. Children discover an early 
inclination to chew whatever is put into their hands. Parents ob- 
serve the inclination, but know not how to apply the remedy. In- 
stead of giving to the child something which may at once exercise 
its gums and afford it nourishment, they commonly put into its 
hands a piece of hard metal, or impenetrable coral. A crust of 
bread, or a hard biscuit not only answers the purpose better than any- 
thing else, but has the additional properties of nourishing the child, 
and carrying the saliva down the stomach, which is a great promoter 
of digestion. 

In feeding children considerable judgment is necessary to propor- 
tion the quantity of food to their age and strength. Weakly chil- 
dren will always require less food than those who are stronger, for 
they are less able to digest it. They are frequently attacked with 
alarming and even fatal convulsions, from their bowels being over- 
loaded. Under all circumstances, if the food is too thick, or given 
in too great a quantity, the perfect digestion of it is prevented. 

It is not necessary to feed a child oftener than five or six times in 
twenty-four hours, and the less it is fed in the night the better. It 
is almost ridiculous error to suppose that whenever a child cries it 



MANAGEMENT OF CHILDREN. 471 

wants victuals, and thus be constantly feeding it both day and night. 
If the child's wants and motions be judiciously attended to, it will 
be found that it seldom cries, but from pain ; and if it be properly 
nursed, and quite easy in its dress, it will rarely cry at all. Nurses 
should be particularly cautioned not to lay a child on its back when 
fed. In the posture of sitting, it swallows its food more easily, and 
more readily feels when it has enough. 

Cleanliness. — The most scrupulous attention to cleanliness, 
during the whole period of childhood, cannot be too strongly incul- 
cated. For the first week or two the infant should be bathed, morn- 
ing and evening, in tepid water, and afterwards in cold water. The 
whole body ought to be washed in the morning, and the lower half 
at night. 

In washing with cold water it is proper to begin with the head, 
and to finish as expeditiously as possible. 

The infant should be afterwards well dried, particularly at the 
bendings of all the extremities, and the whole body and limbs should 
be gently rubbed with dry soft linen or flannel, until a glow of 
warmth appears upon the skin. It is the manner of washing a child 
that secures it from sufTeri ng from the application of cold water. 
The more delicate and weakly an infant is born, the more will cold 
water strengthen it, if well applied ; and, besides its bracing quali- 
ties, it will, by cleanliness, prevent excoriations, and keep off that 
troublesome complaint termed the scald head. 

When the application of cold water has been omitted for some 
days, it will be better to begin with the addition of a little salt or 
some brandy to the water ; lessening the quantity of it gradually, so 
as to leave it off entirely in a few days. 

When children are a few months old, cold bathing may be sub- 
stituted in the room of washing with cold water ; and it may be pro- 
per to add some directions, respecting the mode of dipping a child in 
cold water. Of these, the principal is, carefully to watch for that 
moment when it has taken in a full breath, and then to plunge it 
into the water, and take it out instantly, so that no part of the ac- 
tion of respiration may be necessary during the time of submersion. 
The child will then breathe freely on being taken out of the water, 
and suffer little or none of that agitation which often defeats the 
intention of the practice, and produces a terror when it is to be 
repeated. 

Children should have their linen and clothes frequently shifted. 
How often do we meet with little infants, merely from sloth or igno- 
rance, wearing the same dress for days, and rendered disgusting both 
to sight and smell. Scarcely any other care or advantage can pre- 
vent the child from suffering when cleanliness is neglected. 

Attention should be paid to keep the child dry, and the clothes 
ought to be immediately removed when soiled or wot ; the child 
should also be wiped with a soft sponge, dipped in water. It is won- 



472 



MANAGEMENT OF CHILDREN. 



derful how early an infant may be taught to void the urine and 
stools at proper intervals into a pot. 

Air, Exercise, and Sleep. — If grown persons, who have been 
many years accustomed to impure air, often feel themselves sick in 
a crowded room, it must be very evident, that a much less degree of 
bad air will affect infants, whose lungs are weak and irritable. 

The temperature in which children are kept should be so regula- 
ted as never to be below that which is agreeable to an adult. By 
sudden exposure to cold air, the infant is apt to have cough, or 
stuffing of the nostrils produced; on the other hand, warm apart- 
ments, and especially a neglect of a circulation of air, hurts the 
health, and makes him liable to fits. 

On the proper exercise of infants, more depends than the superfi- 
cial observers could imagine ; for, by inattention to this circumstance, 
a foundation is often laid for diseases, which, though their first ap- 
proaches be slow and gradual, terminate suddenly in a fatal manner. 

It is, therefore, of great importance, both to the population of the 
country, as well as the health of the inhabitants, that parents should 
attentively consider, that the more children are exposed to the open 
air, within prudent bounds, the less they are subject to take cold. 
By exercise in the fresh air, weakly and delicate infants will, 

Acquire a vigour and elastic spring 

To which they were not born. — Armstrong. 

For a week or two the mere washing and dressing of children, 
and the motion which they from time to time make with their arms 
and legs, is productive of sufficient exertion. By degrees, they may 
be tossed or dandled a little, and ought to be occasionally placed on 
a bed to allow them to kick, and move their arms freely. When 
they are able for it, they should be encouraged to creep on the car- 
pet, and even when two or three months old, the feeble and unavail- 
ing attempts they make to move or to raise themselves are useful. 

The age at which infants may be taken out, depends much on 
the season. In warm weather they may be carried out when a 
fortnight or three weeks old, but in winter they must be older. 

At first they ought only to be kept without doors for a very short 
time ; and the person who has charge of them should walk slowly 
and gently, and avoid standing, especially in a current of air. By 
degrees they may be sent abroad twice a-day, when the weather is 
favourable, and may be kept out gradually for a longer space of time. 

Infants sleep much at first, and ought not to be disturbed. In 
this respect, they may be left to their own propensity, and as they 
grow older they sleep less. The only point to be attended to, when 
they become so old as to have the sleep regulated, is to prevent their 
sleeping so much through the day, as would make them restless at 
night. 



MANAGEMENT OF CHILDREN. 473 

A crib is the proper bed for a child. Cradles are hurtful, as the 
rocking is often carried to a dangerous degree, and, besides, they are 
so confined, and generally so closely covered, that the child breathes 
an impure air. 

Nature never intended that infants should have exercise during 
sleep after they have breathed; therefore, the idea, that rocking in 
a cradle resembles the motion to which infants have been accus- 
tomed when in the womb, is an erroneous one. The young of other 
animated beings sleep quietly and profoundly for a great part of 
their time without any rocking, although they also were habituated 
to a gentle waving motion before birth. 

Every restriction to one particular position, in whatever situation 
the infant may be, ought to be constantly guarded against ; for as 
the softness of the bones renders them easily moulded into an im- 
proper shape, deformities, which may destroy the health, or prove 
the source of much future distress, will, if this caution be not ob- 
served, be readily induced. An infant should not, therefore, be laid 
always on the same side, nor carried constantly on the same arm. 

Weaning — Forms an important era in the life of an infant, as on 
the proper regulation of this great revolution in his mode of living, 
his future health often depends. 

The time at which a child should be weaned, depends much on 
his health, and on circumstances connected with the nurse. A deli- 
cate child requires to be nursed longer than one who is stout : and 
where there is reason to suspect a tendency to particular complaints, 
connected with weakness of constitution, or where children suffer 
from teething, or former children have suffered from weaning, it will 
be right to continue the nursing for near a twelvemonth. But when 
the child is vigorous, he may be weaned at nine months, or even 
earlier, if any particular circumstance require it. 

Since there's no help, come let us kiss and part, 
Nay, I have done, you get no more from me, 
And I am glad, yea, glad with all my heart, 
That thus so clearly I myself can free. — Drayton. 

This is, perhaps, one of the severest trials a mother is called to 
endure, when compelled to relinquish the sweet office of nurse to 
her babe. What sensation can equal the rapture of the moment ! 

When the fond mother, bending o'er his charms, 
Clasps the fair nursling in delighted arms; 
Throws the thin kerchief from her neck of snow, 
And half unveils the pearly orbs below ; 

With sparkling eyes the blameless plunderer owns 

Her soft endearments and endearing tones, 

Seeks the salubrious fount with opening lips, 

Spreads his inquiring hands, and smiles and sips. — Darwin. 

59 



474 MANAGEMENT OF CHILDREN. 

Many errors are daily committed in the method of weaning. 
Some women deprive the infant of the breast at once ; and others, 
by the application of mustard or any nauseous substance, to the nip- 
ples, endeavour to make him desert the breast of his own accord. 
Both practices are equally cruel and improper. 

In all cases, the change ought to be made gradually, the child 
receiving more food, such as arrow root, biscuit, jellies, beef-tea, <fcc, 
and less milk for some time previously to weaning. It will also be 
of advantage to accustom him for a few weeks to have no suck early 
in the morning ; nothing from bed-time till an early breakfast. 
Many give drink through the night, which is merely a bad practice. 
By giving food three, or even four times daily, and lessening the 
quantity of milk gradually, as the other diet is increased, children 
very seldom suffer from weaning. The great cause of injury is the 
change of diet, which produces disorders of the stomach and bowels, 
and this, it is evident, cannot be so effectually prevented by any 
method as making the change gradually. 

The practice of giving a child toddy, or laudanum, &c, to make 
it sleep, when it is weaned, is very hurtful, as these injure the sto- 
mach and bowels. 

The infant should be accustomed, w T hen weaned, to receive food 
or drink at stated periods, and not according to the caprice of nurses. 
Although this task will at first be somewhat difficult, it can always 
be accomplished by perseverance : and the benefits which the infant 
itself, and its attendants derive from this circumstance, will more 
than compensate for the trouble attending the attempt. As little 
drink or food ought to be given during the night as possible ; for a 
bad habit may be induced, which may lay the foundation for many 
future complaints. 

Nursing. — Much of the present comfort and future health of a 
child depends upon the nursery maid. 

e What careless dread a mother's breast alarms, 
Whilst her loved offspring fills another's arms, 
Fearful of ill, she starts at every noise, 
And hears, or thinks she hears, her children's cries." 

x4.mong the qualifications required in a nurse, the following may 
be enumerated : — Cleanliness in her person, with a cheerful obliging 
temper ; patience, and a method in all her arrangements ; attention 
to regulate the temperature of the nursery, so as to avoid either cold 
or excessive heat, and to have the clothes always dry and clean ; 
prudence in the diet of the child, and perfect obedience to rules and 
orders. 

As children can be early educated to evil and mischief, it will not 
be denied, that, with equal attention, they may be trained to good. 
And since they are, in some measure, under the control of the nur- 
sery maid, it behooves parents to be watchful, and not to trust their 
offspring in the hands of one not endowed with good qualities. 



MANAGEMENT OF CHILDREN. 475 

"Once exiled from your breast, and doomed to bring 
His daily nurture from a stranger spring ; 
Ah ! who can tell the dangers that await 
Your infant, thus abandoned to its fate V 

Indeed, there is no doubt much of the misery, and many of the 
crimes of human life, have their foundation laid in the nursery; and 
could some of those who have suffered most for their misconduct 
know all the steps which led to it, they would regret that the seeds 
of ungovernable passion, of selfishness, and other vices, had been 
planted before they could discern their right hand from their left. 

It is greatly in the power of a nurse to regulate the disposition of 
a child, as well as to promote its health, by carefully avoiding those 
causes which may have the least tendency to render it fretful and 
peevish, and by removing, as far as possible, every distress on its first 
appearance. 

A child does not cry unless uneasy from hunger, want of sleep, 
pain, or some inconvenience. Bodily uneasiness will, with any 
child, affect the mind, rendering it peevish and irritable, and pre- 
sently, causes which may be called mental, will do the same. For 
a child is not merely an animal machine, it has also a mind capable, 
very early, of feeling various passions. 

As soon as children begin to notice, and to be attracted by sounds 
and objects, the nurse ought to sing in a cheerful and lively strain. 
And we should present, and take away, in a cheerful and amusing 
manner, objects which attract the eye, by which the child is early 
taught to receive, and readily part with, what it desires. 

Now, when his little hands from bondage free, 
Restless expand in new-born liberty, 
You teach the child, with reprehension light, 
In preference to the left to use the right. 

The practice of servants scolding children in jest, and teaching 
them to scold in return, encouraging them to scratch, and revenge 
real or pretended injuries, and to take vengeance on chairs and 
stones, is productive of incalculable mischief. 

And we not unfrequently iind great pains are taken by the nurse 
to inspire the child with terror at the doctor, and at medicine, the 
effects of which are best seen when the child becomes sick. 

We will farther observe, it is through a most criminal inattention 
to children in the nursery, a foundation is sometimes laid in their 
tender minds for those superstitious terrors, from which not all their 
efforts in subsequent life can entirely relieve them. I allude t< 
those dismal stories about witches, spirits, hobgoblins, raw head ana' 
bloody bones, wherewith silly nurses, especially poor blacks, are so 
fond of frightening infants. Considering the importance of deep 
impressions made during those tender years, parents cannot too 
strictly forbid every thing of this sort; neither can they ever exceed, 
in their generous labours, to illuminate the minds of their children 



476 MANAGEMENT OP CHILDREN. 

with lofty ideas of their Creator, and that mighty power which he 
will never fail to exert in their favour, if they will but be good. 

Caution to Parents. — Independently of the means we have 
pointed out to ensure the health of children, and preserve the human 
species, we must have an equal regard to the dispositions of children. 
We consider the health of the mind of even greater importance than 
the health of the body, and indeed they are very intimately con- 
nected ; for what mother can vouch for the health of her babe a 
single day, if she have not command enough over herself and it to 
control its appetites, wants, and desires ; on the due regulation of 
which not only its happiness, but its health, must depend. 

It is to be recollected, that a child has a mind endowed with gra- 
dually unfolding powers and passions ; that when it begins to notice 
and desire, it becomes an object of education and training; and this 
is the time to acquire that ascendency over your children's minds 
which, if properly employed, will ensure you a due degree of influ- 
ence over them through life. Every discreet mother, deeply im- 
pressed with the importance of the trust committed to her, will begin 
by gentle admonition, softened by maternal endearments, to check 
the first indications of obstinacy and ill temper in her child ; for, 
like small weeds springing up in a luxuriant soil, they may, with 
care, be easily eradicated ; but if permitted, by neglect, to take root, 
they will soon overshadow the choicest virtues, or choke them while 
yet in embryo. 

And, should life's olive branches rise 

To bless your fond parental eyes ; 

She who, with all a mother's care, 

The nursling plants can fondly rear ; 

Th' excrescent shoots with firmness prune, 

Each noxious weed with care consume., 

Till nurtur'd by her fostering hand, 

The rising plants grow and expand, 

Bud, blossom, bear — While each survives 

The ripened fruits of virtuous lives. — Polyanthus. 

As soon as children can comprehend language, they may be taught 
obedience, and their inordinate desires should be regulated in such 
a manner as to prevent their becoming so totally unmanageable, as 
is too often the case. For instance, should an infant of eight months 
take a fancy to its mother's watch, as it would be a very improper 
plaything, it should receive a gentle, but firm, denial. It would, 
probably, grieve. Something else should be offered it; and if it 
take it, and be pleased, all will be well. Often as it reverts to the 
watch, the denial must be repeated, and it will soon relinquish the 
expectation, and be perfectly happy with other toys, and so in every 
thing else. On the other hand, should it show resentment when the 
watch is denied, and refuse all other playthings that maybe offered, 
instead of weakly yielding to the storm, and, with mistaken tender- 
ness, giving up the watch, or with anxious care concealing it from 



MANAGEMENT OF CHILDREN. 477 

its sight, still greater resolution must be observed, tempered with ten- 
derness and moderation, as the object must, be to correct the disposi- 
tion. On no account permit it to have the watch, and as often as it 
inclines to dispute the point, let it perceive you are determined. 
After a few lessons of this kind, your word will no longer be disputed ; 
while your children, thus early taught submission, will never require 
any severity whatever. But then our government must be uniform, 
to produce this happy effect. It will not do, because we chance to 
feel out of humour, or it should militate against our own gratifica- 
tions, to deny an infant an indulgence to-day, which, in a paroxysm 
of maternal fondness, we may grant it to-morrow. Be assured, 
children will very soon learn to take advantage of such capricious 
conduct ; and when once they discover that we are irresolute in our 
commands, or may be overcome by resolution and importunity on 
their part, they will not fail to profit by the discovery ; and that by 
such imperceptible degrees, that many a fond mother finds her au- 
thority gone, and her jurisdiction contemned, before she is aware 
that she has, by her imbecility, forfeited the one, or alienated the 
other. Nor is this evil confined to infancy. She will feel the me- 
lancholy effects of failing to substantiate her claim to obedience from 
her children during the docile period of childhood, to the latest 
evening of her life. 

" How sharper than a serpent's tooth it is 
To have a thankless child." 

It is absurd to pretend that a child is inferior to a puppy, and yet 
a puppy may be early rendered docile and gentle, or sulky and ill- 
natured, according as it is educated. 

To tease and contradict infants and children is not the way to 
improve the disposition, or to teach patience ; but it is not imprac- 
ticable to treat them in such a way as to prevent their crying, if 
they do not immediately obtain, or should be deprived of, what they 
desire, whether that be the breast or a shining toy. This is to 
be accomplished, not by stubborn harshness, always hurtful to a 
child, and indicating a savage disposition in those who use it, but by 
prudence. » 

Does any child, at least any one not under the guidance of an 
absolute fool, ever make a practice of crying, because it is prevented 
from grasping the flame of a candle? No, surely; and why? — 
because the mother or nurse will never yield to this ; and very soon 
the child beholds the candle without a wish to do more than look at 
it — yet, the very same child will cry itself asleep, or almost into fits, 
if prevented from scattering the sugar out of the sugar basin. 

Some children, Ave know, are cheerful, good-humoured, lively, 
and little disposed to be petted or fretful, when denied what the) 
wish. Others, equally healthy, are perpetually crying, passionate , 
and cross, if they do not instantly obtain what they desire. Peevish 
ness and crying cannot, when the child is sickly and uneasy, at all 



478 DISEASES OF CHILDREN. 

times be prevented ; but when these propensities exist in health, there 
is no question that the fault lies with the parents. 

It ought, therefore, to be remembered, that on the treatment the 
child receives from its parents during this stage, will, perhaps, depend 
much of its misery or happiness, not only in its passage through this, 
but through the other stages of existence. 

If, on the one hand, every little sally of passion and impatience 
be immediately controlled ; if that which is admissible be regularly 
permitted, and that which is improper as regularly withheld, the 
little creature will soon learn to distinguish that which is allowed 
from that which is prohibited. It will, indeed, urge its claim for that 
which it lias been taught it has a right to ; but will not harass itself 
and its attendants with ceaseless whirlings, or raving to obtain that 
which uniform prohibition has placed beyond expectance. 

But a melancholy reverse appears, if, on the one hand, no consis- 
tency be observed in its management ; if at one time the slightest 
indulgence be refused, and at another the most extravagant, and even 
injurious cravings be gratified ; the child becomes more and more 
fretful, till at length it manifests such ill-nature, as to render it odious 
to all around, and sooner or later the poor little sufferer pays with its 
life the purchase of its early indulgences. 



DISEASES OF CHILDREN, 

REQUIRING EXTERNAL TREATMENT. 

In considering the disease of children, we shall begin with those 
to which the new-born infant is liable from circumstances incidental 
to its birth, or mismanagement soon after it, which require, princi- 
pally, external treatment; and then shall take notice of original 
imperfections. 

Sickness, the minister of death, doth lay 
So strong a siege against our brittle clay, 
As while it doth our weak forts singly win, 
It hopes at length to take all mankind in : 
First, it begins upon the womb to wait, 
And doth the unborn child there uncreate, 
Then rocks the cradle where the infant lies, • 
Where, ere it fully be alive, it dies. — Carew. 

INJURIES IN CONSEaUENCE OF BIRTH. 

When the infant has been detained a long time in the passage, 
the several parts subjected to pressure are liable to be injured. 



DISEASES OF CHILDRExV. 479 

Swelling of the Head. — The most common of these injuries 
are swellings on the head, or alteration of the shape of that part. 
First born children are generally affected with some degree of swell- 
ing on the crown of the head. The edges of this swelling are hard, 
and the middle soft, so that an experienced person would suppose 
that the bones of the head were deficient at that part. It will com- 
monly subside in a short time. But when a tumour remains on any 
part of the head, a cloth dipped in equal parts of spirits and vinegar, 
and applied two or three times a-day, will soon disperse it. 

The practice among nurses, therefore, of endeavouring to give the 
head a proper shape by squeezing and pressing it with the hands, 
&c, is unnecessary, and ought never to be allowed, on account of 
the dangers which may be the consequence. 

Scratches or Marks on the head require no particular atten- 
tion, as they soon disappear. 

Injuries of the Face. — In some cases, where the infant has 
come down in an unusual direction, the face is much affected : the 
eyes being inflamed, the nose flattened, the lips swelled, the features 
distorted, and the colour of the countenance livid. These frightful 
appearances usually go off in a few days, when no violence has been 
done by improper interference during the delivery. 

Swelling of the Breasts. — The breasts of children sometimes 
swell and inflame, especially if attempts be made to press out forci- 
bly a milky fluid, which they often contain. If the pressure of the 
clothes be avoided by their being put on loosely, it will generally go 
off without any application. However, it is sometimes necessary to 
rub the part gently with warm olive oil ; and in cases of such in- 
flammation, equal parts of spirits and vinegar must be applied cold, 
by means of soft linen, or poultices of the crumbs of bread, and lead 
water or milk, should be employed for its resolution. If, from mis- 
management, they should suppurate, a warm milk and bread poul- 
tice, is to be frequently applied, and when the tumour bursts, me 
part is to be dressed with simple ointment. 

Swelling of the Scrotum. — The Scrotum will also be re- 
markably tumid, and even discoloured, particularly when a child 
has been born by the breech presentation. In this case it will be 
proper to suspend it by a cloth, after first covering it with a piece of 
linen, wetted with brandy, which should be frequently renewed. 

Injuries of the Limbs. — The limbs are in some cases fractiwed 
or dislocated, by the rashness and awkwardness of the practitioner. 
These accidents, on some rare occasions, unavoidably happen from 
the situation of the infant ; but are most frequently to be attributed 
to ill-directed attempts to accomplish the delivery. 

From whatever cause these disagreeable occurrences originate, 
they should never be concealed from the attendants ; but, on the 
contrary, the proper means to remedy them should be immediately 
adopted. 

Management of the Navel. — From neglect, or from a bad 



480 DISEASES OF CHILDREN. 

constitution of the child, the navel sometimes, after the cord drops 
off, becomes very tender and excoriated, giving a good deal of trou- 
ble. Great attention is to be paid to cleanliness. It is to be bathed 
twice or thrice a-day with infusion of camomile flowers, and after- 
wards with a solution of ten grains of white vitriol in six ounces of 
rose water. A bit of singed rag is usually employed as the dressing, 
but when this sticks firmly, a little simple ointment may be used. 

If there should be more than usual tenderness, it may be proper 
also to sprinkle it with a little prepared chalk or starch. In some 
instances there is a discharge, and the part continues raw : then it 
will be proper to apply three or four pieces of soft cabbage leaf, laid 
one over another, that they may be preserved moist and cool, and 
continued as long as the discharge may continue considerable. The 
bleeding, which sometimes happens at the navel, is of such little 
consequence, that a light compress, with some gentle styptic, and 
secured by a sticking plaster or bandage, soon removes it. The sore- 
ness, when considerable, may require a milk and bread poultice, and 
the exhibition of some mild laxative medicine. 

Sore Eyes. — Children, within a few days after birth, in conse- 
quence of exposure to much light or a strong fire, or from other 
causes, some of them operating during delivery, have sometimes in- 
flammation of the eyes. The eyelids swell, and the inside, as well 
as the white of the eye, become red, and covered with a quantity of 
yellow purulent matter, which comes out at the corner of the eye, 
which hardening, tends to glue the lids together. In some cases the 
eyelids are a little swelled : in others their insides are turned out, es- 
pecially when the infant cries. If this be neglected, specks may 
form on the eye, or the disease may be communicated to the eyeball, 
and suppuration take place within, destroying vision for ever. 

The cure consists in guarding against exposure to large fires, much 
light, or cold ; and in bathing the eyes, morning and evening, with 
a little warm milk and water, and twice or thrice through the day 
with a very weak solution of sugar of lead, or of white vitriol. 

When the inflammation is considerable, a blister to the nape of 
the neck, and the occasional use of a grain of calomel at bed-time, 
or the cathartic mixture (see Dispensatory,) in doses of a tea- 
spoonful every hour or two, to keep the bowels in a laxative state, 
are proper. 

Should the eyelids stick together, the edges should occasionally 
be anointed with simple cerate, or a little mercurial ointment, and a 
drop of the vinous tincture of opium, or equal parts of laudanum and 
water, applied with a camel's hair pencil into the eye four or five 
times a-day. 

Excoriations. — From the delicate texture of the skin of infants, 
excoriations readily take place whenever one part of it is in constant 
contact with another, unless the most careful attention be paid to 
keep every part dry. 

The inflammation termed galling-, which so frequently occurs in 



DISEASES OF CHILDREN. 431 

the groin, between the legs, and on the neck of an infant, evidently 
arises from inattention to cleanliness, and from the use of coarse or 
new pilches.* 

The cure will be easily effected by washing the parts often in 
cold water, and, after being wiped dry, dusting them with prepared 
chalk or starch. But if they have been neglected, and become 
fretted, they require to be washed frequently, with a solution of ten 
grains of white vitriol, in five ounces of rose-water. If the excoria- 
tions are situated about the genitals, it may also be proper to apply 
a thick mucilage of gum Arabic, or to cover the part with a little 
fresh saturnine or simple cerate, to defend it from the action of the 
urine. 

Slight ulcerations, behind the ears of infants, are also very com- 
mon, and only require to be washed daily with cold water, and co- 
vered with a single rag to keep the cap from sticking to them. They 
are sometimes beneficial, especially during bowel complaints, or 
teething, and will get well and break out again into very foul sores, 
several times, without any cause for alarm. 

However, when these sores become extensive and painful, it will 
be proper to apply a blister to the nape of the neck, to draw off the 
heated serum, and to give now and then a few grains of magnesia, 
and rhubarb, or the absorbent and aperient mixture. (See Dispen- 
satory.) The sores should also be well washed with Castile soap 
and water, and dressed with an ointment composed of one drachm 
of calomel and one ounce of simple cerate, mixed well together, and 
spread on each side of a double linen cloth, which must be applied 
twice a-day. 



ORIGINAL IMPERFECTIONS. 

Infants are not always born in a state of perfection with respect to 
the structure of their bodies ; for, sometimes they have deficient, su- 
perfluous, or misplaced parts. Many of these imperfections admit 
of no remedy, while others may be easily rectified. 

Flesh Mark. — The most frequent of these imperfections is the 
flesh mark, or redness on the skin, resembling a stain with a bram- 
ble. This may occur on any part — the face, the body, or the fin- 
gers. It has been attributed to the effect of the mother's imagina- 
tion, or to a fright, but without any sufficient cause. It is met with 

# If children were attentively held over a pan for a month or two, it would 
be found that they are more cleanly than people suppose, and would super- 
cede altogether the use of cloths, either by night or daw 

60 



482 DISEASES OF CHILDREN. 

when no such circumstance has occurred, and, on the other hand, it 
is wanting in those cases where, if this had the supposed effect, we 
would chiefly expect it. The mark may be more or less extensive, 
and of different shades of colour. It proceeds from the collection 
of a great many blood vessels, by which the structure of the part is 
altered. By pressure, the redness disappears, for the blood is forced 
out, but it immediately returns. When it becomes elevated and en- 
larged, then there is an evident pulsation in the part. It grows with 
more or less rapidity, and at last bursts, and discharges sometimes an 
alarming quantity of blood. 

Pressure applied early, when the mark is on such a part as to 
bear it, is frequently an effectual means of removing it, or at least of 
preventing all tendency to enlarge. The application of some stimu- 
lant or astringent to the part, if it be small, the cuticle being previ- 
ously removed by a mild blister, and also, occasionally employing 
pressure, will be found useful. 

Hare-Lip — Is so well known as to need no description. The 
treatment of the hare-lip must be varied according to many circum- 
stances, which can only be determined by an experienced surgeon. 
If the child can suck, the operation by which alone the blemish can 
be removed, should be deferred till he be several months old at 
least, as the parts will then be better adapted for retaining the pins 
by which the cure is accomplished. But when sucking is prevented, 
the operation may be tried, though it affords only a forlorn hope. 

Tongue-Tied. — Infants are born with a thin membrane under 
their tongue, called the frcenum, which is sometimes so broad as to 
require dividing, in order to give freedom to the tip, and to allow the 
child to take proper hold of the nipple in sucking. 

If the tongue is not bound down, and if the child suck the finger 
when put into the mouth, there is no reason for saying he is tongue- 
tied. The operation, where it is really necessary, is very trifling ; 
but if incautiously performed, the artery below the tongue may be 
opened, and much blood lost. 

It is easily divided by a pair of sharp scissors, and the operation 
can never be attended with any inconvenience, or hemorrhage, if it 
be done with proper caution. 

Club-Foot. — The gristly state of the bones of the foot renders a 
cure in most cases practicable, when the proper means are begun 
immediately after the birth; but if the deformity be not attended to 
till the infant be some months old, it will be difficult and precarious. 

The method by which this disease can be removed is very simple. 
It is merely the application of proper means to reduce the foot, in 
the most gradual manner, to its natural situation. These should not 
be continued only till this is effected, but ought to be kept applied 
constantly for several weeks after, in order that the deformity may 
be completely removed. In the most favourable cases, the cure 
cannot be completed within less than several months and it often 
requires even a much longer time. 



DISEASES OF CHILDREN. 483 

Natural Passages.— Sometimes the natural passages, particu- 
larly the bowels, may be shut up, the nostrils or eyelids may be 
closed, or the fingers may adhere, or have fleshy attachments, like 
additional fingers. These cases admit of cure only by a surgical 
operation, by which the natural passage is opened, and afterwards 
secured from closing again by the introduction of a bougie. 

The vagina of the female is so sometimes imperforated. Parents 
should, therefore, carefully examine the infant, that it may not grow 
up with a defect, which, at a certain period of life, must inevitably 
prove troublesome, and which, at last, will require an operation to 
relieve. 

Infants have sometimes a discharge from the vagina, a few days 
after birth ; resembling matter ; but it is of no consequence, as it goes 
off of itself in a short time. 

When a child does not make water, the use of a silver probe will 
ascertain whether there be any obstruction, and if there be not, it 
promotes the discharge. 

Sometimes an infant will be very long, perhaps, a day or two, be- 
fore it voids the urine, where no defect or obstruction is to be seen. 
It will then be proper to rub the belly with some warm brandy 
mixed with a little oil. Some have recommended it to be rubbed 
with an onion. Which ever be used, it is advisable immediately af- 
terwards to apply to the belly a bladder half filled with scalded bran, 
or camomile flowers, or hot water; and lest by some accident it 
should burst, it would be proper to enclose it in a second bladder. 
A clyster of thin gruel, with a little oil, should be given ; and if ne- 
cessary, a tea-spoonful of castor oil may be swallowed. If the child 
is in considerable pain, a few drops of laudanum may with propriety 
be added to the clyster. 

Ruptures— Are very common complaints among infants ; but 
are fortunately not attended with so much danger as similar disorders 
in grown people. The kind, which is in general most immediately 
dangerous, is that which takes place at the navel, where a great part 
of the bowels may be forced out, covered only with a very thin and 
almost transparent skin. If this be so large, that the intestines can- 
not be pressed back, the child generally dies, in consequence of the 
tumour inflaming or going into mortification. But if the bowels can 
be pressed back, and, especially if the skin of the tumour be not very 
delicate, there is no risk. The application of a compress, and a 
suitable bandage round the belly, keeps the intestine in its place, 
and in the course of some time the aperture closes so far as to pre- 
vent the protrusion. 

A broad piece of flannel, in the form of a roller, together with a 
piece of adhesive plaster applied over the part, by affording a safe 
and firm support, prove extremely useful. 

When they happen in the groin, all that can be done, is to bathe 
the part occasionally with equal parts of brandy and vinegar, keep 



484 DISEASES OF CHILBREK. 

the body open, use the cold-bath, and prevent the child from crying, 
as much as possible. A bandage cannot easily be applied with effect, 
to so young a patient, though it is still worth a careful trial. In 
proportion as the infant acquires strength, these troublesome com- 
plaints disappear. And nothing is more conducive to this than the 
continued use of the cold-bath, and paying attention to the state of 
the belly, as costiveness always aggravates the disease. 

There will often appear in the scrotum of infants, at birth, a tur- 
gesence, which has been called the watery rupture. Of this it is 
proper that parents and nurses should be aware, that it may not be 
mistaken for the true rupture. From this it will be readily distin- 
guished by its being elastic, as it cannot be made to disappear by 
pressure, and by its not becoming larger when the infant cries. If 
it be placed between the eye and a lighted candle, at night, it will 
be seen to be transparent. It will generally be cured by compresses 
moistened with vinegar and water, with the addition of as much 
brandy as the skin is able to bear, or by the repeated application of 
cloths dipped in a solution of two drachms of sal ammoniac in eight 
ounces of water. But the best method is to puncture the bottom of 
the tumour with the point of a lancet, which is attended with very 
little pain, and soon effects a cure. 

Another little complaint like the watery rupture, is tumefaction 
of the prepuce, which also arises from extravasated water, and is a 
partial dropsy of the skin. The complaint will be removed in a few 
days, by washing the parts frequently with lead-water, or by apply- 
ing a poultice made with it and the crumbs of bread, and by keep- 
ing the bowels open. 



DISEASES OF CHILDREN, 

REQUIRING MEDICAL TREATMENT. 

Before we proceed to the consideration of those disorders requiring 
medical treatment, it may be proper to give a hint in regard to the 
doses of medicine. In prescribing for children, the chief difficulty 
lies in fixing the appropriate dose ; and hence medicines more fre- 
quently fail with them, or are over-dosed, than with the adult. As 
a direction, therefore, it is proper to examine, in a general manner, 
the proportions fit for this early period of life. 



DISEASES OF CHILDREN. 485 

Thus, seven years require half the dose of an adult. 
Three years . . . the fourth. 
One year ... the sixth. 

One month . . .the tenth. 

With these proportions in view, where no peculiarity of constitu- 
tion exists, the doses stated will generally succeed. 



SNUFFLES. 



This term is given to a disease, which generally affects children 
within the month, and most commonly in the first or second week, 
on account of the noise made in respiration. The discharge is much 
more abundant than that which attends common cold. It is from 
the first purulent and thick, and afterwards turns thin. 

Children afflicted with this malady are always of a weakty, un- 
healthy habit ; and though having apparently no particular com- 
plaint, they seem incommoded from a stoppage of the head, which 
is particularly perceptible in sleep when their breathing is difficult 
A purple streak is observable on the verge of the eyelids, as an at- 
tendant on this disorder, with a general fulness externally, about the 
throat and neck. Its duration extends to several weeks ; and when 
it departs, it is usually succeeded by a disorder of the bowels and 
other complaints. 

This disease appears with various degrees of violence. The chief 
symptom that gives uneasiness here is the difficulty of breathing 
through the nose, which arises from an inflammation of the mem- 
brane that lines the posterior nostrils and throat. By this inflamma- 
tion extending, every part comes to be affected, even to the stomach 
and bowels ; and hence the great and increasing debility it quickly 
occasions. The stools are thick and pasty, and of a peculiar green 
or blue colour. 

From this account of the disorder, the state of the bowels is a cir- 
cumstance which must be more attended to, than in almost any other 
disease. To this end, one or two tea-spoons full of castor oil should 
be given every day, so as to procure four or five evacuations daily. 
The bark should be given in a decoction or clyster, joined with cor- 
dials, to support the strength of the child. The same remedies 
should be exhibited to the wet nurse. 

The acrimony of the discharge on the adjacent surfaces of the 
nose and throat, should be prevented by washing the parts frequently 
with warm camomile, or elder-flower tea, and afterwards applying a 
little sweet oil. Where convulsions are threatened, or occur, lauda- 
num is very proper, after the operation of laxative medicines ; and 



486 DISEASES OF CHILDREN. 

in many cases, the anodyne should be given two or three times 
a- day. In this disease, blisters are improper, as tending to produce 
gangrene of the part. 



CUTANEOUS AFFECTIONS. 

Infants are much subject to an eruption called the gum, which 
assumes a considerable variety in its appearance in different cases, 
and even in the same individual. 

Red Gum — Is the most common, and usually appears a short 
time after birth, and occasionally recurs till all the milk teeth are 
cut. The red gum of infancy, consists of a number of small, red, 
elevated spots. The top is clear, and the base is of a vivid red. 
This eruption is scattered over the trunk of the body, and sometimes 
on the cheek and forehead. On the feet the spots are still larger, 
more distinct, and sometimes a clear fluid is found at the top. When 
the redness round the base is considerable, the rash has at first sight 
an appearance of measles ; but there is no fever, nor sneezing, nor 
watery eye, nor cough: on the contrary, the infant is in perfect 
health. In general, it is necessary only to keep the bowels open 
with the absorbent and aperient mixture, or magnesia, and to keep 
the child moderately warm; otherwise, the rash striking in, may fall 
upon the bowels and puduce fever. 

Yellow Gum — Is merely a species of jaundice, but is, in gene- 
ral, of very short duration. It affects most children in a greater or less 
degree, and usually appears within a week, or much earlier after 
birth. It proceeds from the absorption of bile, and is known by a 
yellow colour of the skin, or even of the eyes, and is preceded, and 
attended by sleepiness and carelessness about sucking. 

It is readily removed by the exhibition of three or four grains of 
ipecacuanha, or a few drops of antimonial wine, to excite vomiting, 
and by keeping the bowels open by the occasional use of calomel, 
the absorbent and aperient mixture (see Dispensatory,) or a watery 
infusion of rhubarb. Should the symptoms continue, the emetic 
ought to be repeated after two or three days, and one or other of the 
above aperients given every other day. 

White Gum — Appears after the period at which infants are sub- 
ject to the former variety ; consisting of a number of white, hard, 
elevated spots, the base of which is sometimes, but not always, sur- 
rounded with a little redness. It resembles the itch, and is some- 
times mistaken for it : but it is not infectious, nor is it itchy, unless 
the child be kept dry, and the parts are irritated. It requires no 
particular treatment; merely cleanliness and attention to the bowels. 
In speaking of this eruption it may be proper to mention, that there 



DISEASES OF CHILDREN. 487 

is also another, which still more resembles itch, though it generally 
is rather later appearing than the white gum. It consists of soft, 
smooth, shining elevations of the skin, forming small papulae, or 
eminences, differing little in colour from the neighbouring skin. 
They are itchy, and if the top be scratched off, a clear water oozes 
out ; and if the scratching be frequently repeated, they become red 
and bloody, or covered with a dark little scab. By washing with 
soap and water, and rubbing the parts three times a-day with lemon 
juice, or a solution of borax and vinegar, the complaint may be re- 
moved ; but if this be neglected, it may become similar to the itch, 
and require the same remedies. 

Tooth Rash — Consists of very small red spots, or papulae, set so 
closely together, as to form patches from the size of a six cent piece 
to that of a dollar, especially on the extremities : whilst on the body 
the papulee are larger, more inflamed, and, at a distance, look like 
measles. This requires only a gentle laxative occasionally. 

Milk-Blotch — Is another cutaneous disease, which appears on 
lusty children, especially about the time of teething. It is a scabby 
eruption, which generally appears first on the cheeks, or forehead, 
and then spreads over the face. The pustules are red, and the top 
soon becomes covered with a scab, consisting of different layers. 
This often puts on a very unpleasant appearance, but it is neverthe- 
less of an innocent nature; and it has been observed that those 
children who have been much loaded with it, have usually been 
healthy, and have cut their teeth easily. A remarkable circumstance 
attending this eruption is, that however thick and long continued the 
scabs may be, the crusta lactea never excoriates, nor leaves any scar 
on the parts, unless improperly treated. 

The milk-blotch is itchy rather than painful. It generally pro- 
ceeds from too full diet, or a plethoric habit, and, therefore, requires 
not only to have the diet lowered, if the child be weaned, or the 
nurse fed upon less animal food, if on the breast, but also, to have 
occasionally a laxative. Local applications should be used with 
caution ; but if the eruption be very itchy and troublesome, and do 
not yield to a change of diet and laxatives, it may be washed with 
lime-water, or the saturated solution of borax in vinegar three times 
a-day, or with a scruple of sal-ammoniac, dissolved in six ounces of 
rose or spring water. 

The anxiety parents and nurses often express to have those ugly 
appearances removed, has induced many practitioners to interfere 
unnecessarily and improperly. It should always be remembered, 
that such eruptions are critical and salutary; and, therefore, when 
from excessive itching it becomes necessary to apply to them any of 
the above washes, or a weak solution of sugar of lead, or, what is 
preferable, a weak solution of white vitriol, gentle laxatives are to 
foe given. 

An eruption very similar to the above, frequently takes place 
during teething, and is a most obstinate and troublesome complaint. 



488 DISEASES OF CHILDREN. 

rendering the infant extremely restless, from the heat, itching, and 
irritation which attend it. Besides the period of attack, there are 
other circumstances which distinguish this eruption from the former; 
namely : there being a redness of the skin round the edge of the 
incrustations; an ichorous or clear-coloured exudation, which con- 
cretes, issuing from the surface of the scabs ; and the disease having 
a tendency to spread over every part of the face which is touched 
with that exudation. 

The ordinary unctuous applications generally aggravate this affec- 
tion. The best remedies, therefore, are brisk laxatives, as an infusion 
of senna and manna, rhubarb or salts, and cream of tartar, sometimes 
sulphur and a wash composed of linseed oil and lime-water, or of 
one part of the acetate of ammonia in four parts of spring water, or 
half an ounce of borax in a gill of sharp vinegar. With either of 
these, the scabs may be washed evening and morning. 

Copper-coloured Blotches. — Eruptions of this kind on the 
buttocks or soles of the feet, occurring from within a week to a fort- 
night after birth, indicate a diseased state of the infant's habit, which 
requires the most serious attention. If they be neglected, ulcerations 
of the palate, throat, and nostrils follow. Should the child be nursed 
by another than the mother, the nurse's nipples, armpits, and throat 
become affected. 

The only 'cure for this affection is mercury, which ought to be 
exhibited both to the nurse in such doses as will affect her milk, and 
also to the infant in doses adapted to its strength. — (See Venereal 
Disease.) 

Erysipelas or Rose — Is a very formidable disease with infants. 
It appears generally at an early period, commonly within a few days 
after birth. It most commonly first appears on the toes or fingers, 
which look swelled and bluish, as if from cold ; but sometimes it 
begins at the belly, or about the shoulder or neck, or at the inside 
of one or both thighs, accompanied with fever. The part is of a 
purple or livid colour, and is to be distinguished from other affec- 
tions by the hardness and uniform increased thickening of the 
inflamed skin. 

The best practice at the outset, is to dust the part very frequently 
with fine flour or hair powder, and keep the bowels open with gentle 
doses of calomel and Epsom salts. If suppuration take place, the 
abscess ought to be early opened. (See St. Anthony's Fire.) 

Both infants and children are subject to other eruptions of the 
skin, than those we have enumerated, of which it is impossible to 
convey an accurate idea by mere description. But we will observe, 
as a general rule, that all eruptions, however different in forms and 
appearance, may be divided into two classes ; namely : those of a 
temporary, and those of an indefinite duration. The former are 
commonly ushered in with symptoms of general indisposition; the 
latter break out gradually, without any derangement of the ordinary 
health. The former are owing to some disorder of the stomach or 



DISEASES OF CHILDREN. 489 

bowels, or some interruption of the usual excretions or secretions. 
The latter are, probably, in most instances, the effects of some dis- 
eased condition or action of the lymphatic system, though sometimes 
they may be occasioned by a local affection of the skin itself. In 
all cases where symptoms of indisposition, such as heat, restlessness, 
sickness, or oppression, a few grains of ipecacuanha, or, what is pre- 
ferable, a dose of calomel that shall both vomit and purge, together 
with the warm bath, should the first prescribed, and afterwards occa- 
sional purgatives with absorbents, and a suitable regulation of the 
diet, are to be advised. But where the eruption is accompanied by 
fever, or marks of indisposition, some of the medicines termed altera- 
tives, as calomel in very small doses, antimonial wine, salts, sulphur, 
&c, are the remedies chiefly to be depended upon. In some cases, 
other topical applications, besides the warm bath, are required to 
allay the irritation, arising from the excessive heat, and itching of the 
skin. The most efficacious are, milk and water, decoction of bran, 
the saturated solution of borax in vinegar, weak solution of white 
vitriol or potash, the acetate of ammonia, much diluted, and equal 
parts of lime-water and oil. 

When the body is much covered with eruptions, and they remain 
long out, attention should be paid to their not being repelled sudden- 
ly by any exposure to cold, or by any other improper treatment; but 
should they happen to strike in, we may then have recourse to the 
tepid bath and light cordials, as wine whey, in order to solicit their 
return to the surface, which will be of the greatest consequence, 
should the child suffer from the repulsion. 

These cutaneous affections will be found owing either to some ill 
quality in the breast milk, a heating regimen, or errors in diet. It is 
only necessary to avoid the occasional causes, and the infant will 
not be troubled with them. 



THRUSH, OR SORE MOUTH, 

Is an eruption of white spots, resembling little pieces of coagulated 
milk, generally appearing within the mouth, on the lips and inside 
of the mouth, and sometimes affecting the whole alimentary canal. 

This disease is apt to affect the nipple, producing excoriation ; 
whilst on the other hand, a sore nipple may produce thrush. In 
general, it proceeds from a disturbed state of the stomach and bowels, 
occasioned by giving too much spoon-meat. It may also be pro- 
duced by exposure to cold, damp weather, and some peculiar states 
of the atmosphere. 

In three or four days these spots grow yellow, and soon after drop 
61 



490 DISEASES OF CHILDREN. 

off, and gradually disappear, leaving the skin on which they have 
been seated of a bright red colour. It is usual for nurses to have im- 
mediate recourse to borax ; but although this may clean the mouth, 
it does not remove the cause, and, if early employed, the spots will 
quickly reappear. 

In the treatment of this complaint, the most approved practice is 
to give a dose of rhubarb and magnesia first, which generally corrects 
the disordered state of the bowels ; and for two days, or until the 
spots begin to change their colour, a tea-spoonful of cold water, or a 
liquor prepared by mixing with the white of one egg, three table- 
spoonsful of cold water, and a little white sugar, should be frequent- 
ly put into the mouth. When the spots become yellow, borax and 
honey, in the proportion of one drachm of the former, finely pow- 
dered, to an ounce of the latter, and well mixed together, will have 
an excellent effect in cleansing the mouth, and healing the ulcers, 
especially when the milk adheres much to its surface. A little of 
this paste may be put on the child's tongue, as often as may be ne- 
cessary to keep the parts clean ; which will be licked to every part 
of the mouth, and will effectually do, without putting the infant to 
pain, by forcibly rubbing it on. But the cure is not permanent, un- 
less the occasional causes be avoided, and the absorbent and aperient 
mixture, (see Dispensatory,) or magnesia, be given to subdue the 
feverish state of the system. 



SICKNESS AND YOMITING. 

Infants, sometimes, are very suddenly seized with a sickness, and 
an inclination to vomit, which they resist as long as possible. This 
adds greatly to their distress, and prolongs it. The breath is sour or 
ill-smelled, the eyes inanimate, the lips slightly livid, the counte- 
nance ghastly, and the child loathes the breast. These appearances 
are highly alarming to an observer, and, if the child have been 
previously complaining, will indeed indicate great danger. But 
when they come on suddenly, especially if the stomach have been 
loaded, or some improper food given, the death-like aspect presently 
passes off. The child is speedily relieved, first by vomiting, and 
afterwards by sleeping. If there be no appearance of spontaneous 
vomiting taking place, four or five grains of ipecacuanha should be 
given. 

Vomiting is a frequent occurrence with infants, and is not to be 
considered as morbid, unless it be attended with sickness, ill-smelled 
breath, and discharge of cheesy or sour stuff. Thriving children 
puke often after sucking ; but then they generally throw up only a 
mouthful at a time, without straining, or being ill. This requires 



DISEASES OF CHILDREN. 491 

no medicine. But vomiting, accompanied with sickness or paleness, 
and dull appearance, demands attention. It either proceeds from 
disorder of the stomach, and, in that case, is relieved by a gentle 
emetic, and if necessary, rubbing the pit of the stomach with a little 
laudanum ; or it is a symptom of some serious indisposition, or affec- 
tion of the head, which must be determined by the presence, or con- 
comitant appearance, of other symptoms, such as fever, screaming, 
drowsiness, spasms, &c. Vomiting depending on teething is distin- 
guished by the state of the mouth. 



COSTIVENESS 

Is natural to some children, and acquired by others. When con- 
stitutional, it is better to do but little, particularly if the child be 
healthy in other respects. But, if the child, after having been some 
weeks open, become costive, and do not thrive, or if from the first 
it have been costive, is pale and delicate, and is subject to fits of 
crying, there is no doubt of the propriety of interfering. It is better 
to interfere too soon than too late. 

Calomel is generally a safe and useful laxative, and may be given 
at first every day, for three or four days, in such a dose as to make 
the bowels rather open ; half a grain, a grain, or even more, accord- 
ing to the effects, may be employed. This practice often prevents 
the continuation of costiveness, or, if it do not, some other laxative is 
to be given daily, or once in two days, to procure an easy stool. 
We may employ the syrup of senna, (see Dispensatory^) calcined 
magnesia, manna, or sulphur, and occasionally, in place of these, a 
suppository or dry clyster. 

Temporary costiveness may be at any time removed by a supposi- 
tory made of a small piece of yellow soap, shaped like a large writ- 
ing quill. This may be rendered more powerful, if necessary, by 
being dipped, previously to use, into some powdered salt. Another 
excellent suppository is prepared by scraping a candle until it be ren- 
dered sufficiently small and tapering to introduce it into the anus 
about an inch, or two inches at most. It will be better to dip it in 
oil before used. A strip of paper or linen cloth twisted up, and well 
moistened with oil, is easily introduced, and forms also a good sup- 
pository or dry clyster. 



492 DISEASES OF CHILDREN. 



COLIC PAINS. 



The delicacy of the bowels of infants renders them affected by the 
most apparently trifling causes ; and hence many circumstances in- 
duce colic pains, which are known to exist by the drawing up of the 
infant's limbs, and by its agonizing manner of crying. Colic may 
be induced by costiveness, by cold, by damp clothes, by the liberal 
use of spoon-meat, particularly if the bread have been a little sour, 
by some fault in the milk, or it may accompany thin and slimy purg- 
ing, which is sometimes produced by the injudicious use of magnesia 
or other laxatives. 

In slight degrees of colic, applying warmth to the belly, and giv- 
ing the child a little fennel tea, generally afford relief. But in the 
more violent and dangerous kind of colic, the treatment must be va- 
ried according to the circumstances of the individual case. If it 
seem to arise from accumulated slime, or from some fault in the 
milk, suitable doses of cold-pressed castor oil, or magnesia and rhu- 
barb, together with the warm bath, or fomentations of the belly are 
to be advised. But if the bowels be quite open, and the complaint 
have been excited by exposure to cold, or some external circum- 
stance, along with the warm bath it will be proper to rub the belly 
with some laudanum. When constipation attends colic, the most 
active means of opening the bowels are to be had recourse to. For 
this purpose large doses of calomel, followed by castor oil, together 
with laxative clysters, are required. 

It is a common practice to give carminative medicines to infants, 
in order to remove flatulence, such as gin and water, grated ginger, 
and spices of different kinds. These ought never to be employed 
when the infant is the least feverish, or when the bowels are in a 
costive state. If any flatulence remain after costiveness has been re- 
moved, and there be no febrile symptoms, a drop or two of lauda- 
num, or double the quantity of paregoric, in fennel tea, may be 
given with advantage. Dr. Burns recommends the following mix- 
ture in doses from ten to twenty drops in a little water, as being al- 
ways safe, and generally effectual, in ordinary cases of colic. Take 
two drachms of tincture of assafoetida, twenty drops of oil of anise or 
fennel seed, and an ounce of mucilage of gum Arabic, rubbed up 
together with a lump of sugar. 



CONVULSIONS. 



The convulsions of children are generally preceded by slight 
symptoms of distortion of the face, as involuntary laughter when 



DISEASES OF CHILDREN. 493 

asleep or awake, squinting of the eyes towards the nose, or turning 
them upwards, the child, at the same time, changing to a bluish co- 
lour. The fit itself is distinguished by distortions, more or less gene- 
ral, according to the violence of the attack. 

Convulsions may be produced by wind, or irritation in the bowels, 
dependent on worms, costiveness, indigestible food, acrid stools, &c, 
or by teething, by breathing confined air, by the striking in of some 
eruption, or by the affection of the brain itself. When convulsions 
occur suddenly in a state of previous health, they are frequently at- 
tended with little hazard ; but when they occur in the course of 
some other disease, which the child has been labouring under for 
some time, they are highly dangerous. 

When a child is seized with convulsions, a great consternation im- 
mediately prevails, and without some determinate rules, either noth- 
ing will be done, or very contradictory plans may be adopted. 

The first general rule, in such cases, is to order the tepid bath, 
which is proper in every instance. When the motion is strong, it 
allays it ; when it is slight, it brings on a state of quiet repose. The 
water should be agreeably warm to the hand, and the child should 
be kept in it up to the neck for some minutes, if he do not get relief 
sooner. If he be very pale or languid, the addition of a table-spoon- 
ful of mustard or hartshorn to the bath is useful. 

Secondly, Whilst the child is in the bath, a common injection is 
to be prepared, and administered immediately after he comes out ; 
and afterwards a dose of calomel, proportioned to his age, is to be 
given. 

Thirdly, If the child seem to be sick, or oppressed in breathing, 
or about the stomach, or have been known to have had something 
which has disordered the stomach, vomiting should be excited by 
tickling the throat with a feather during the fit, or giving ipecacu- 
anha as soon as the child can swallow. 

Fourthly, After the child is taken out of the bath, it will be use- 
ful to rub him, particularly over the spine and the stomach, with oil 
of amber, or with spirits, having about a sixth part of hartshorn ad- 
ded. If any rash have struck in, rubbing the surface with campho- 
rated oil of turpentine, or applying a small warm plaster over the 
stomach will be useful. 

Fifthly, If the gums be swelled, or there be any appearance of 
teething, the part should be instantly scarified. And when they 
proceed from worms, the remedies detailed in that disease are to be 
employed, 

The convulsions, or inward fits, of infants a day or two old, require 
chiefly gentle laxatives, such as magnesia and rhubarb, or calomel, 
and sedulous attention to nourishment, with gentle friction over the 
surface, especially of the belly, with camphorated spirit of wine. 



494 DISEASES OF CHILDREN, 



TEETHING. 



The symptoms that mark dentition are, heat and swelling of the 
gums, and a tendency to drivel or slaver much, with starting and 
thrusting of the fingers into the mouth. 

There are only twenty teeth evolved in infancy, ten in each jaw, 
and these are not permanent. They, generally, begin to appear be- 
tween the sixth and eighth months, and the two middle incisors, or 
front teeth of the lower jaw, usually come through first, and, in 
about a month, the corresponding teeth above appear. Then the 
two lateral incisors below, and next those above come out. About 
the twelfth or fourteenth month, the first, or anterior double teeth, 
appear on each side below, and then above. Between the sixteenth 
and twentieth months, the space between the first teeth and grinders, 
is filled up with those which are called the eye-teeth, and from this 
time till the thirtieth month, the other back teeth appear; so that 
when the child is two years and a half old, he, generally, has all his 
milk teeth. These continue till it is six or seven years of age, and 
then are succeeded by others, which are stronger, and more perma- 
nent. Many children cut their teeth with great ease, but others 
suffer considerably. On inspecting the gums of a child, that is not 
teething, they are found to be sharp, and the skin which covers 
them, seems even to form an edge or seam along the gum. But 
when a tooth is growing up, the gum, and the skin which covers it, 
are put on the stretch, and the appearance of seam at that part is lost. 

In the treatment of the effects of teething, we have chiefly three 
objects; First, to allay irritation: Secondly, to alleviate urgent 
symptoms : and, lastly, to support the strength. 

Fii*st, It is customary to give the child a gum stick, to rub on the 
itchy gum ; but if this be made of any hard substance, it is apt to 
injure the gum, or the child may knock it into his eye. — A crust of 
bread is often employed, but if a piece of it break off in the mouth, 
the child may be choked. The fingers are instinctively used, nor is 
there any risk of the child, by being indulged in this respect, acquir- 
ing afterwards a bad habit. The most effectual means of allaying 
irritation, is to cut the gum when it is distended or swelled. This 
is often indispensably necessary for the removal of urgent symptoms ; 
it generally gives much relief, and is always safe and innocent. It 
does not, even if the incision should heal, render the future progress 
in any degree more tedious. It is not painful, but gives, on the 
contrary, immediate ease. 

Experience teaches us that a costive state of the bowels adds 
greatly to irritability of the system ; and, therefore, if there be no 
looseness, it is always proper to give gentle laxatives, such as rhu- 
barb and magnesia, during dentition. Cool air is highly useful, but 
the child is not to be imprudently exposed to a great degree of cold. 



DISEASES OP CHILDREN. 495 

It should be frequently out, and ought to have the cold bath in the 
morning, and be washed with cold water at night. 

When there is considerable irritation, rubbing the spine and sur- 
face of the belly with a little laudanum, is useful. 

Secondly, In the treatment of urgent symptoms, we must, besides 
cutting the gum, which is a general rule, have recourse to such 
remedies as the particular nature of the affections requires. When 
die fever is high, that is, when the skin is very hot and the pulse 
quick, it is proper to give laxatives, and use the warm bath, morning 
and evening, in the place of cold water. If the child be lusty and 
drowsy, indicating a tendency to affection of the head, it will be 
necessary to give a pretty smart dose of physic, and apply either one 
or two leeches to the forehead, according to the age. If these means 
do not speedily relieve the child, the head should be shaved and a 
small plaster put on. We never have cause to regret having used 
prompt and decided means of preventing danger, but have much 
oftener to reproach ourselves with not having used early, those reme- 
dies which the result of the case shows to have been proper. 

Purging, if severe, or attended with weakness or emaciation, is to 
be restrained by giving clysters with laudanum ; and, occasionally, 
small doses of calomel, magnesia, and rhubarb, or the absorbent and 
aperient mixture, when the stools are unnatural. 

Sickness, loathing of food, and ill-smelled breath, are relieved by 
a gentle dose of ipecacuanha. 

A short cough, as well as tenderness of the eyes, will be removed 
by a Burgundy pitch plaster, applied to the back. Ulceration of the 
gum requires gentle laxatives ; and the strength is to be supported, 
and the parts bathed, with port wine and water. 

Thirdly r , The strength is to be carefully supported under the irri- 
tation, by the breast milk, or if the child be weaned, by beef-tea, 
arrow-root, tapioca, sago, rice-milk, milk and water, &c. In some 
cases, where the child is recently weaned, it will be of advantage to 
give it the breast again. If it do not take sufficient food by the 
mouth, nutritive clysters must be resorted to. In every instance 
nourishment is essential ; but in some, particularly when the weak- 
ness is increasing, cordials, such as wine whey, must be added. 



LOOSENESS, OR CHOLERA INFANTUM. 

A purging is one of the most frequent complaints of infancy ; 
however, it should be remembered that it is not always a disease ; 
but on the contrary, it often proves a remedy. By it, nature com- 
monly throws off an offending cause. Its causes, therefore, and 
treatment, require very particular attention. 



498 DISEASES OF CHILDREN. 

Both vomiting and purging very often arise from unwholesome 
milk or other food ; from teething, from a moist cold air, as well as 
from the sudden disappearance of some eruption on the skin. The 
purging is not then hastily to be stopped ; until the offending cause 
be removed. 

The treatment, therefore, of this complaint, must consist first in 
removing, as far as possible, the irritating matter, and then checking 
the particular symptoms. If the offending cause appear lodged in 
the stomach, the cure should begin by giving an emetic, or a dose 
of calomel, that will both vomit and purge ; and afterwards small 
doses of rhubarb, or the absorbent and aperient mixture. (See Dis- 
pensatory.) 

The nature of this disease is to be often drawn from the appear- 
ance of the stools ; and the treatment ought, in a great measure, to 
be regulated from that circumstance. Thus, when the stools are 
sour and curdled, after the necessary evacuations have been pre- 
mised, the absorbent mixture, or prepared chalk, or magnesia, in 
suitable doses, combined with grated nutmeg, or some aromatic, is 
strongly pointed out, in addition to opening machines. — When again 
the stools are slimy, and of a clayey colour, in addition to the former 
plan, injections of soap-suds are not to be omitted, and Castile soap 
dissolved in milk will be found a useful drink. When the stools are 
watery and bloody, or fetid, castor oil and calomel are the best pur- 
gatives ; and if attended with much griping, clysters of milk and 
soap-suds should be often repeated. 

The extent and continuance of this plan, must depend on the 
obstinacy of the complaint. To these medicines, opiates, according 
to the age of the child, may be given with the greatest advantage at 
bed-time, provided there exist no febrile symptoms. 

When the child is cold and languid, the purgative medicines ought 
to be joined with some aromatics, as grated ginger, and given less 
frequently: and during the intermediate days, as well as the even- 
ing after the physic has operated, a cordial diet, such as the addition 
of wine or gruel, or arrow root, with plenty of nutmeg, should be 
allowed. The occasional exhibition of injections of thin starch and 
laudanum, in the proportion of ten drops of the latter to two table- 
spoons full of the former, must be had recourse to, in order to mode- 
rate the discharge when the strength is much reduced. 

Beside this internal treatment, the warm bath, or bathing the 
child, night and morning, in a strong decoction of oak bark, will be 
found exceedingly beneficial. External applications are also of the 
greatest service, as cloths moistened with the camphorated spirits, or 
wrung out of brandy stewed with spices, and applied warm to the 
belly and extremities. Blisters to the legs and arms, have also their 
good effects, and ought to be repeated in obstinate cases. Wearing 
flannel next the skin, or a bark jacket, will also prove an auxiliary. 
A soft flannel bandage, passed frequently and with some degree 



DISEASES OF CHILDREN. 497 

of tightness, round the body, immediately over the stomach and 
bowels, is found to be a very useful remedy in this complaint. 

In the treatment of all abdominal complaints, much attention is 
necessary to the nature and kind of food or nourishment taken. 
The food of children, with this view, should be deprived of acid as 
much as possible ; hence, instead of milk, animal food, in the form 
of beef tea, or mutton broth, is preferable. When there is an habi- 
tual disposition to purging, there is no diet superior to arrow root ; 
and when this is not at hand, flour baked in an oven till it breaks 
into a powder, and afterwards made up with boiled milk, is a good 
substitute. Tapioca and sago are also very nutritious. Indeed, it 
is proper to alternate the food occasionally, from one kind to another, 
and frequently to exhibit the animal food in a solid form, when the 
stomach rejects fluid nourishment. The change of the wet nurse 
sometimes makes a necessary part of the treatment ; and when a 
child has been weaned, resuming the breast has often had the hap- 
piest effect. 

Although powerful astringent medicines are commonly inadmissi- 
ble in cases of purging during infancy, great benefit has sometimes 
seemed to accrue from the use of a mixture composed of twenty 
grains of toasted rhubarb, two drachms of prepared chalk, a table- 
spoonful of brandy, previously set fire to and allowed to burn as 
long as any spirit remains, and three table-spoons full of water. — 
The dose is from one to two tea-spoons full every hour or two while 
awake. The dewberry root boiled in milk (see Materia Medica,) 
will also be found a valuable astringent medicine in this troublesome 
complaint. In several hopeless cases burned cork (see Page 314,) 
has wonderfully succeeded. 

In many instances, a change of air, alone, has proved an effectual 
remedy, after every other means had failed. 



DISCHARGE FROM THE VAGINA. 

Infants have sometimes a discharge from the vagina, a few days 
after birth, resembling matter ; but it is of no consequence, as it goes 
off itself in a short time. 

Children of five or six years old are subject to a mucous discharge 
resembling the genuine whites of adults, which will, in some in- 
stances, be in an excessive quantity, so as to run through all their 
clothes. The disease readily yields to a little cooling physic, as the 
cathartic or absorbent and aperient mixture, and keeping the parts 
perfectly clean with soap-suds or lead-water. When it is obstinate, 
balsam copaivi maybe given thrice a-day; and, if the child be puny, 
the tincture of steel is a suitable remedy. 
63 



498 DISEASES OF CHILDREN. 



WORMS. 

The symptoms enumerated as most commonly distinguishing 
worms, are pain and eructation of the stomach, variable appetite, foul 
tongue, fetid breath; the belly full, hard and tense, with occasional 
gripings or pains in different parts of it, particularly about the navel; 
irregular state of the belly, heat and itchiness of the fundament, 
urine white and limpid, and often discharged with difficulty. With 
these symptoms are joined a dull appearance of the eyes, often dila- 
tation of the pupil, itchiness of the nostrils, short dry cough, slow 
fever, with evening exacerbations and irregular pulse, grinding of 
the teeth in sleep, &c. 

However, many of the above symptoms occur in other diseases ; 
and I believe, as was suggested to me by the learned Dr. Caldwell 
of Philadelphia, that worms are much oftener suspected to be the 
cause of children's complaints, than what they really are. 

For the cure of worms, two indications arise; first, to expel them, 
and secondly, to prevent their generation. — The first may be effected 
by giving a dose of calomel at bed-time, and rhubarb the next morn- 
ing, to work it off. — The pink-root (see Materia Medica,) has long 
been held in high estimation as a vermifuge. It may be given in 
the form of tea, with milk, sweetened, for breakfast, observing not 
to continue the use of it, if it be found to affect the child's eyes. 
The bark of the pride of China (see Materia Medica,) is much 
extolled of late as a remedy for worms. My friend Dr. Grimes, of 
Savannah, said, that he considered it one of the best vermifuges we 
are acquainted with. He directs a tea to be made of the bark of 
this tree, and as much of it taken during the day, as the child can 
bear without producing vomiting, purging, or considerable weakness 
of the limbs. 

External applications have also been found useful for the removal 
of this complaint. These consist of a liniment made of equal parts 
of beef's gall, aloes, and sweet oil, or fresh butter, rubbed on the 
belly every night; or a plaster made of dry rue and aloes, or 
gall mixed up with a little turpentine and lard, and applied over 
the region of the belly, taking care to cover the navel with a piece 
of cotton. 

The future generation of worms will be prevented by avoiding 
greasy food, and by taking the rust or tincture of steel thrice a-day, 
joined with bitters to give tone to the bowels. 



DISEASES OP CHILDREN. 499 



WATERY HEAD. 

This disease is distinguished by pain of the head, accompanied 
with nausea, sickness, and other disorders of the animal functions, 
without any evident cause, and sudden in their attack; variable 
state of the pulse ; constant slow fever ; and in the advanced stage 
of the disease, dilatation of the pupil of the eye, with a tendency to 
a comatose state. 

It most frequently takes place between the age of two and ten 
years, and with children of a scrofulous habit. It may, however, 
arise from falls and blows on the head. 

The first stage of the disease is marked by loss of appetite, and a 
degree of melancholy and uneasiness without the child being able 
to fix on any particular cause. Pain in the head is next felt, espe- 
cially above the eyes, and in a direction betwixt the temples. In 
very young subjects, pain in the head is indicated by the child put- 
ting his hand often to his head, and waving it about. This pain 
gradually extends, and is at last felt more particularly in the arm 
and leg of one side. The affections of the stomach next commence, 
and alternate with pain and uneasiness of the head. The febrile 
symptoms, though pretty constant, are milder in the morning, but 
suffer also an evening exacerbation. Vomiting occasionally occurs, 
but costiveness is a leading symptom. The tongue is little affected, 
except towards the end, when it assumes a scarlet colour, and some- 
times becomes apthous. As the disease advances, all the symptoms 
of hectic are conspicuous, and during the whole disease the child 
shows a strong propensity to the bed, or a desire to avoid being 
moved. 

This disease is truly inflammatory in its commencement, and can 
only be treated with success by the early employment of those means 
which are best calculated to subdue inflammation ; such as copious 
and repeated bleedings, the application of leeches or cups, blisters to 
the head and temples, and an issue behind the neck. 

Besides these external remedies, active purges, as calomel and jalap, 
must be frequently administered, and, if possible, a ptyalism should 
be produced by the use of mercury, either in the form of calomel in 
small doses, or by rubbing in the unction. 

If acid prevails, the absorbent mixture (see Dispensatory,) must 
occasionally be given, and during the continuance of fever, the 
tincture of digitalis or foxglove (see Dispensatory,) will be found an 
auxiliary. 

After subduing the inflammatory action of the system, opium or 
laudanum may be employed with advantage, to relieve the spasm, 
or pain of the head, when it is considerable. In the last stage of 
the disease, cold bathing, and the use of tonic medicines, may be 
required to invigorate the system. 



500 DISEASES OF CHILDREN. 



CROUP, OR HIYES. 



This disease, peculiar to children, is a species of asthma, with 
violent catarrhal symptoms. It is most common in low marshy 
countries, or on the sea coast, and in wet and cold seasons. Indeed, 
it is readily occasioned by any thing wet or damp, or which obstructs 
the perspiration. 

There are two species of croup, the acute, or inflammatory, and 
the chronical, or lingering. 

The former is attended with a very quick pulse, cough, hoarse- 
ness, and difficulty of breathing, soon after, and sometimes even 
before the occurrence of the croaking noise, which is the characteris- 
tic of this disorder. As the disease increases, the pulse quickens, the 
heat augments, and an excessive restlessness takes place. The 
breathing becomes more and more difficult, and laborious, and the 
peculiar wheezing sound which accompanies it, so increases, as to 
be heard at a considerable distance. 

The symptoms continue to increase in violence, until a spasm of 
the muscles of the parts taking place, the patient is suffocated, the 
disease often completing its course in the space of three or four days 
and nights. 

The extreme degree of danger which always accompanies this 
disease, and the rapidity with which its symptoms proceed, show that 
immediate remedies are requisite to arrest its progress. Therefore, 
on the first appearance, blood-letting, both general and topical, should 
be employed, and repeated two or three times a- day, according to 
the violence of the symptoms, and the habit of the patient. Imme- 
diately after bleeding, an emetic should be administered, and the 
sickness kept up for several hours, or even days, by small doses of 
the antimonial solution. (See Dispensatory.) 

Inhaling the steams of hot vinegar and water, and embrocating 
the throat with the volatile liniment, have also their good effects. 
Besides which, the application of a cataplasm of mustard, or blister 
to the throat, are not to be neglected, if the symptoms are the least 
alarming. 

The decoction of seneca or rattle-snake root, (see Materia Medi- 
cal) is a valuable medicine in this dreadful complaint. It should be 
given at first in such doses as to excite vomiting, and afterwards in 
smaller doses, to keep up a nausea at the stomach, and to produce 
perspiration. Onions (see Materia Medica,) are also celebrated as 
a sovereign remedy. 

The tincture of digitalis, or foxglove is considered by some a good 
remedy, if employed in the early stage of the disease. Attention 
should always be paid to keep the bowels open by castor oil, or some 
aperient medicine. 

The most speedy and efficacious of all remedies, in this alarming 



DISEASES OF CHILDREN. 501 

disease, which has come under my notice, is calomel in very large 
doses. For this valuable remedy, J candidly acknowledge myself 
indebted to my excellent and very learned friend, Professor Davidge, 
uf Baltimore. 

From him I have been imboldened to use it, in desperate cases, 
in doses of from thirty to sixty grains, to children. On my own 
daughter, only four years old, and apparently in the very act of suf- 
focation, I used it in the dose of at least sixty grains. The cure was 
almost instantaneous. Among other instances of cure as surprising, 
was one in the infant of my amiable friend, Mrs. Chalmers, lady of 
the Rev. Mr. Chalmers, of Washington, with the dose of forty 
grains. The cure was so immediate, that the overjoyed parent in- 
sisted I would instruct her in the remedy, for fear, on the next at- 
tack, I might not be in the way to prescribe. On learning I had 
given her infant, not more than three or four years old, forty grains 
of calomel, she was excessively frightened, and exclaimed, "You 
have killed my child!" and indeed she could hardly be persuaded 
for some time, though her eyes told her the contrary, that I had not 
killed her child. 

So powerful is the effect of this medicine, that it suddenly removes 
the disease without having recourse to other means. It acts on the 
stomach, bowels, and skin. In cases not very alarming, I have 
given calomel in smaller doses, conjoined with ipecacuanha, with 
good effects. 

The flax-seed syrup is peculiarly beneficial in all diseases attended 
with cough, and, therefore, should not be omitted in this. To pre- 
vent a relapse, and to restore the strength of the patient, it will be 
proper, at the close of this complaint, to use the cold bath and to give 
bark in any form which is most agreeable and convenient. 

The latter, or chronical croup, is produced by spasm and unac- 
companied with fever. A most important remedy in this species, if 
earty used, is the warm bath, immediately followed by a clyster, to 
which some of the juice of raw onions may be added. A tea-spoon- 
ful or two of the juice may also be given by the mouth, and some 
applied externally. (See Materia Medica.) If the symptoms do 
not yield to this treatment, an emetic should be administered, and 
after its operation, a dose of laudanum will be proper. 

Some children are troubled with this complaint for several years, 
and then seem to outgrow it. A flannel shirt, light diet, cold bath, 
change of air, gentle exercise, and whatever strengthens the body, 
are the best preventives. 

This disease is almost peculiar to infancy and childhood, while 
inflammation of the larynx and bronchial tubes occurs at all ages. 

It is a rare thing to see this disease in one above twelve years of 
age.* Many who were supposed to have died of croup, proved upon 
post-mortem examination to be bronchitis. 

* General Washington and Josephine, consort of Napoleon, died of this 
disease. 



502 DISEASES OF CHILDREN. 

Symptoms. — This disease usually begins like a catarrh, the symp- 
toms more or less severe with some degree of fever preceded by 
silliness. The voice soon becomes hoarse. The fever symptoms 
increase. And in a day or two, the breathing becomes more and 
more impeded, particularly during inspiration. At last the breath- 
ing becomes stridulous and the voice shrill. Sometimes masses of 
lymph are discharged, resembling portions of false membrane. As 
the disease advances, the expression of countenance becomes more 
anxious. The lips and cheeks have a swollen, livid appearance, 
alternating with a deadly paleness. Pulse is frequent and small. 
The little patient is feeble and restless. 

The body is hot, yet the extremities are cold. At last the body is 
covered with a cold, clammy sweat, and the child dies of suffoca- 
tion. This disease not unfrequently begins in the throat, and thence 
spreads into the air-passages. 

Treatment. — This disease of all others, demands promptitude 
and decision. If the false membrane mentioned above be allowed 
to form, not one of a hundred will be saved. Regarding the treat- 
ment of croup, great diversity of sentiment exists. According to 
some, bleeding and blisters are mainly to be depended on, while 
others think them injurious. When the disease has just commenced, 
and before the membrane has begun to form, bleeding, if ever, is 
then of essential service ; whereas after five or six days have elapsed, 
bleeding must prove the death of the patient. This statement is in 
accordance with the experience of the most able practitioners. The 
same remark applies to the use of leeches ; if employed at an early 
stage, they are of service — if not, they prove injurious. Emetics are 
to be employed, especially at the commencement of the disease. 
The most efficacious is the tartar emetic, two grains in two ounces 
of water, a tea-spoon full every five minutes, till vomiting is pro- 
duced. Its counterstimulant effect is serviceable even if it is diffi- 
cult to produce its effect. We are told by good authority that cold 
affusion has been of signal advantage, when every other remedy has 
been tried in vain. Respecting the use of calomel, the medical 
world is divided in opinion, some thinking highly of it, while others 
condemn it altogether. 

If used at all, it should be employed in very minute doses. Bron- 
chotomy or making an incision into the wind-pipe has been recom- 
mended and occasionally practised with success. Spasmodic croup 
is an affection, consisting entirely of spasm. It is supposed to be 
produced by cerebral irritation, causing some morbid action in the 
nerves that supply the muscles of the throat, and which, by pro- 
ducing a convulsive spasm, occasions the contractions of the larynx. 
In the treatment of croup two things are to be kept in view. First, 
to subdue the local inflammatory action. Second, to promote the 
discharge of the viscid secretions collected in the throat. To this 
end let emetics and the warm bath be employed as soon and promptly 
as possible. In the onset of the complaint, purgatives should be 



DISEASES OF CHILDREN. 503 

employed. After the inflammation has been in a great measure sub- 
dued, the polygata senega has been of sovereign use. It is best 
given in decoction. An ounce of the root, to a pint of boiling water 
suffered to simmer fifteen or twenty minutes, and then sweetened 
with honey. Dose, an ounce every hour or two, according to the 
urgency of the symptoms. It is affirmed the false membrane is 
formed by a whitish fluid which begins on the surface of the tonsils, 
thence spreads over the surface of the pharynx and oesophagus, and 
also the larynx and trachea. This matter is said to be effectually 
removed by one scruple of the nitrate of silver to an ounce of dis- 
tilled water. It must be applied to the tonsils and adjacent parts. 
Insufflation of finely powdered alum has had the same effect. 



WHOOPING COUGH 



Is a contagious disease, attacking in paroxysms of a convulsive 
suffocating cough, with a loud noise or whoop at each respiration, 
and generally terminating by vomiting. It is clearly the effect of a 
specific contagion of a peculiar nature, and highly active, affecting, 
like the small pox and measles, but once in life. 

The treatment of this disease must be regulated by the degree of 
fever and spasm. When the fever is considerable, bleeding becomes 
clearly indicated, as well as blisters over the breast, and the use of 
laxative medicines, together with such as may determine to the sur- 
face ; of which class, the decoction of rattle-snake root, (see Materia 
Medica,) or the antimonial solution is to be preferred. 

When the spasmodic state is most predominant, and the symptoms 
of fever mild, emetics will be highly useful, followed by a dose of 
the anodyne sudorific drops (see Dispensatory ,) at bed-time. If a 
free use of the flax-seed syrup be insufficient to allay the cough, 
laudanum, or paragoric, when fever does not forbid, may be given 
with the greatest advantage. 

In this tiresome disease, I have found no remedy, when there is 
little or no fever, superior to the following mixture, in doses of from 
thirty to sixty drops or more, given m syrup or tea, three or four 
times a-day, until a slight strangury be excited. Take of tincture 
of bark, one ounce and a half; paragoric, half an ounce; tincture 
of cantharides, one drachm. — Mix. The strangury usually comes 
on about the third day, and the whooping-cough seldom continues 
longer than a few days afterwards. 

A grain of assafoetida, administered four or five times a-day, proves 
oftentimes a very useful remedy in cases of whooping-cough. 

When the disease is recurrent, and returns some time after its ap- 
parent departure, as it frequently does on taking cold, an emetic, a 



504 DISEASES OF CHILDREN. 

dose or two of castor oil, and the anodyne sudorific drops, laudanum, 
or paregoric, at bed-time, as the symptoms may indicate, will quickly 
remove it. A milk and vegetable diet is peculiarly proper in this 
complaint ; and, when the patient is debilitated, a change of air and 
tonic medicines, as the bark or Columbo, will be found necessary. 



RICKETS 

Consist in an enlargement of the head, belly, and joints, flattened 
ribs, and general emaciation, with a bloated or florid countenance. 
This disorder generally takes place from six months to two years of 
age, and arises either from unhealthy parents, or from the children 
being improperly nursed, kept wet, dirty, in a close damp air, with- 
out due exercise. 

Weakness and relaxation being the cause of this complaint, its 
remedy must of course be to promote digestion, and to brace and 
strengthen the solids. Hence a nutritious and cordial diet, with 
exercise in the country air, is indispensable. Along with this, the 
cold bath and tonic medicines, as bark, Columbo, and steel, to warm 
and invigorate the constitution, are peculiarly proper ; but they could 
not be entered upon, without previously purging with calomel and 
jalap. The tincture of rhubarb {see Dispensatory^) should also be 
occasionally employed, to keep the bowels in a regular state. How- 
ever, nothing will be found more effectual in recovering the patient, 
than a generous diet and cold bathing, particularly in salt water. 
Sea bathing constitutes, perhaps, the most promising remedy in this 
disease. 



ST. VITUS'S DANCE. 

The diseases called chorea, or St. Vitus's dance, occurs, most fre- 
quently from the age of eight years to the period of puberty. It ap- 
proaches with languor, and indifference with regard to the usual 
amusements ; a variable, and sometimes a keen appetite, continued 
costiveness, occasionally combined with a flabby, lank state of the 
belly, but much oftener with a hardness and swelling, particularly 
at the lower part. The stools are not of natural appearance. Pre- 
sently convulsive affections of the face take place, and are succeeded 
with twitches and starting of the extremities. The patient often 
cannot walk easily, in consequence of one leg twisting in before the 



HYDROPATHY, OR WATER-CURE. 505 

other. He is perpetually changing his position, and fidgetting when 
sitting. 

This disease generally proceeds from, or is connected with, a cos- 
tive state of the bowels ; and nothing gives so essential relief, as re- 
gular and continued purging. When the patient is old enough to 
swallow aloetic pills, two, or sometimes more, of these, may be taken 
twice or three times a-day; or where these cannot be used, infusion 
of senna, Epsom salts, or other purgatives, must be employed; and 
it will be found that usually, though not always, the stools are fetid, 
or unnatural in their appearance. This, so far from weakening the 
patient, has a contrary effect ; for although he may, perhaps, have 
five or six stools in a day, the pulse becomes stronger, the counte- 
nance brighter, the step firmer, and the gesticulations or twitches 
abate, and, at last, after a period, varying from a fortnight to several 
weeks, or some months, the cure is completed. The cold bath and 
tonics may sometimes be useful; which have been introduced into 
general practice, and with success, by Dr. Hamilton, sen. ' 

$J~ Scald Head, and other diseases peculiar to children, which 
have not been noticed here, will be found in the preceding part of 
this work. 



64 



HYDROPATHY, 

OR WATER-CURE. 



Vincent Priessnietz is the founder of this method. He is a native 
of the mountains of Austrian Silesia in Germany. Having crushed 
his finger and finding the usual applications of little benefit, he 
plunged his finger in cold water, and was surprised at the relief he 
obtained. It soon healed. He met with an individual suffering 
from fractured ribs, and recollecting his finger he wrapped the pa- 
tient's body in sheets dipped in cold water. He was equally suc- 
cessful in this case. Priessnietz now began to make some stir in the 
neighbourhood. He cured several others applying to him. An in- 
dividual with cold hands and feet, he relieved by sweating the body 
and then sponging it with cold water. When the patient was much 
debilitated by the perspiration, he threw open the windows. The 
burning sensation on the skin and the oppression were relieved by 
drinking cold water. Far from checking, it increases the perspiration. 
Patients who could not be made to sweat were wrapped in sheets 
dipped in cold water and wrung out. This succeeded in a remark- 
able manner. Such was his success with the use of cold water that 
he soon began to resort to seat-baths — foot-baths — head-baths — eye- 
baths — the douche, &c. &c. # 

Priessnietz use of cold water restoring many to health, whom the 
faculty had failed to relieve, there were not wanting those who at- 
tempted to put an end to what they were pleased to style " the mis- 
chief." The laws against all sorts of quackery were severe. Some 
alledged that the sponge he used, contained some sort of remedial 
property. As the use of any thing medicinal was against the law, 
except by a physician, a commission of doctors was instituted to ex- 
amine into the matter. They could detect nothing. The search 
was in favor of Priessnietz. One doctor prosecuted him for quackery, 
swearing it was he that cured a certain man of the gout, and not 
Priessneitz. The man was examined and duly questioned. He 
affirmed the doctor relieved him of his money — but Priessnietz of 
his gout. In Graefenberg in 1841, Priessnietz had five hundred 
patients of all ranks and conditions. And of the three thousand 
patients in two years whom he had treated, it is affirmed he only 
lost two. 

*This compendium of Priessnietz mode is taken from Shew's excellent 
work on the Water-Cure. 




HALT BATH 



Hf-AD BATH 




SWEATING 



utkksu'i.wtim; 



HYDROPATHY, OR WATER-CURE. 507 



SWEATING. 

In order to produce perspiration, the patient is laid upon a woollen 
coverlet. It is wrapped around him, carefully bringing it in close 
contact with the body in order to retain the heat. The excess of 
caloric thus confined produces a free exhalation from the skin. As 
soon as a perspiration ensues, the windows are opened, and cold wa- 
ter given to drink to promote it. From four to five o'clock in the 
morning is considered the best time for this process. It may occupy 
from a half to three hours. The patient afterwards undergoes the 
cold bath. Thence he passes into the fresh air. Those who are 
found unable to walk are rubbed with wet cloths, then with dry ones. 



WET SHEET. 

The patient is laid upon it — his body is enveloped in it, being 
made to come into close contact with it. He is then enveloped in a 
blanket and bed-covering. , In acute fevers this is changed every 
quarter of an hour, till the skin becomes soft and disposed to sweat. 
He remains in this several hours. He is then taken to undergo a 
tepid ablution. 



COOLING BANDAGES. 

These have the same effect upon any part of the body that the 
wet sheet has upon the whole body. They are folded from four to 
eiffht times and renewed as often as from five to ten minutes. 



WARMING OR STIMULATING BANDAGES. 

A piece of linen is folded two or three times, and being dipped in 
cold water, is wrung out and applied. This is not to be changed 
till dry. It is secured from the action of the air by a dry bandage, 
so that the part may be raised in temperature. This combined ac- 
tion of heat and moisture is serviceable in indurations, tumours, 
swellings, &c. &c. 



RUBBING WET SHEET. 

This is a linen sheet of coarse quality and is allowed to hold con- 
siderable water. It is not to be wrung out. It is thrown over the 



508 



HYDROPATHY, OR WATER-CURE. 



head and around the neck, so as to give a slight shock. With one 
end of the sheet, a smart friction is used for five or six minutes, till 
the skin becomes red and warm. This is followed by coarse, dry 
cloths. 



ABLUTIONS. 

This is performed with a sponge dipped in cold water, and fol- 
lowed with a warm, dry towel. The best time for using this is in 
the morning. 



PLUNGING BATHS. 

The patient remains in this from six to eight minutes, often only 
from two to three minutes, the water being from 40 to 50 degrees. 
Exercise to be taken after. 



HALF BATH. 

This is employed in cases where the invalid is unable to bear a 
whole bath. The water is about 60°. Priessnietz also used sitting 
baths. Head baths. Eye baths. Finger baths. Leg baths. Tooth 
baths. Drop baths. Shower baths. 



THE DOUCHE. 

This is so contrived that a stream of water is made to fall upon the 
body with more or less force. The water is simply conducted into a 
channel, giving it a fall of from twelve to twenty feet and to the 
stream, a calibre of half an inch to five inches. It should not be 
used either when the body is quite cold, or in a state of perspiration. 
The stream is not all at once to be received upon the body, but one 
or more portions of the body to receive it first. The Douche is the 
most powerful stimulant known in Hydropathy, and is applicable 
where excitement is necessary. 



DRINKING. 

The quantity of water directed by Priessnietz was from eight to 
twelve tumblers daily. The greatest quantity to be taken before 
breakfast, less before dinner, and the least before supper. None to be 
drank while the body is very cold. The less the quantity taken at 
meals, the better. The purity of the water is of the utmost importance. 



HYDROPATHY, OR WATER-CURE. 509 

Our limits forbid going into detail. We subjoin a single example 
illustrative of the treatment by the water-cure. 



INFLAMMATION OF THE STOMACH. 

The patient is placed in a half-bath at a temperature of 75 degrees, 
the water of which reaches above the stomach. During the bath, 
he drinks water in small quantities, but often. While in the bath 
his body is washed, and rubbed by two attendants; the stomach not 
exempted if the pressure can be borne. After the lapse of a quarter 
of an hour, if the pain be somewhat abated, the bath is made some- 
what cooler. At the expiration of half an hour the patient is con- 
veyed into bed, wrapped in a wet sheet, and a bandage over the 
stomach wrung out in cold water. When the patient has passed 
some time in this state, and his position becomes irksome, he is 
washed in water of a moderate temperature, a well-wrung bandage 
applied to his body, and is returned to bed w 7 here his covering is so 
regulated as to keep him warm. If he incline to eat, water-gruel is 
given. This process is undergone several days. 



CROUP. 

" It is known by a dry, hollow, barking, whistling, or stridulous 
cough. As soon as we see symptoms indicative of this disease, we 
must wrap the patient without delay in a well-wrung wet sheet, and 
apply a well-wrung bandage around his throat, and thus endeavour 
to promote perspiration. With the appearance of the exhalation 
from the skin, the dangerous symptoms will generally be relieved, 
the cough becomes loose, the voice alters, and respiration more free. 
While the patient is in the wet envelopment (sheet and blanket) 
water-drinking is not essential ; but if he have thirst, it may be al- 
layed with chilled water. If, with the appearance of perspiration, 
amendment ensue, it will not be necessary to change the applications 
to the throat, nor the sheets ; we should rather allow the patient to 
remain eight or ten hours in moderate perspiration which we may 
regulate by loosening or tightening the envelopment. The tempera- 
ture of the apartment should be moderate. An oblution of cold 
water should follow this proceeding, when the patient is to be re- 
turned to bed and lightly covered, to keep up a slight action of the 
skin. Exacerbations are apt to occur at midnight, when our utmost 
care will be needed. The use of the wet sheet in this case must not 
be neglected. The same applications to the throat are to be repeated 
when an amendment does not ensue." 



HOMCEOPATHY 



The author of this system of medicine, is Samuel Christian Fre- 
derick Hahnemann of Meissen in Saxony. He was born in 1755. 
He studied at Leipzic and Vienna, and received his degree from the 
University of Erlangen.* 

The author of the Homoeopathic system seeing the futility of all 
human reasoning upon the principle of life, and observing the ex- 
travagances into which physiologists have been led, has regarded 
such knowledge as belonging to the Deity alone. And shrouded in 
like obscurity, he has considered the intrinsic nature and essence of 
diseases. Here he confesses himself in ignorance. Disease accord- 
ing to him is an aberration of the vital principle in the organism de- 
termined by different morbific causes, acting upon the nervous sys- 
tem, which show themselves by various painful sensations, by various 
functional derangements and by the changes of the tissues and other 
phenomena. 

Hahnemann was educated by his father in the observance of the 
strictest truth, and to account for every thing he did. With such 
sentiments he entered upon the practice of medicine. He soon found 
himself beset with many conflicting statements. 

It was not long before he quit a profession so little congenial to his 
exalted intellect and directed his attention to natural science and 
general literature. It was in 1790 while occupied with the transla- 
tion of Cullen's Materia Medica, that he was struck with that author's 
praises of the effects of cinchona in numerous diseases which seemed 
to conflict with the prevailing notions on the subject. 

It occurred to him as the only sure method of ascertaining the 
true action of this article in disease, to try its effects upon an indi- 
vidual in a state of health. To this end he took several consecutive 
doses of cinchona in the morning and found that a fever was the 
consequence in the evening. He observed that this affection returned 
during several days at the same hour. To the mind of Hahnemann 
this was, what the observation of the apple was to the genius of New- 
ton. Such was the origin of Homoeopathy. He thought he saw the 
reason why cinchona cured fever — that it did so by producing a disease 

* For this brief outline of Homoeopathic medicine we are indebted to the 
Organan, the works of M. Croserio, Dunsford and Everest — and in many 
places we have copied the words verbatim. 



HOMOEOPATHY. 511 

similar to the one for which it was prescribed. To confirm his belief, 
he repeated these experiments with different medicinal substances. 
He found that mercury produced affections resembling syphilis, 
which it cures. It produced ulcerations, inflammatory swellings, 
discharges from the genital organs, swelling of the inguinal glands, 
ulcers of the throat, <fcc. &c. Sulphur, he found, produced affections 
of the skin analogous to those of the itch. Those who have fre- 
quented sulphur baths, have experienced an eruption with itching 
which continues long after the baths have been relinquished. From 
his experiments he deduced this proposition : that the more nearly 
the effects of a remedy on a healthy individual resemble the symp- 
toms of disease, the more rapid and complete the recovery of the 
patient. During the lapse of twenty years he made his experiments 
with perseverance which laid the foundation of his system, called 
Homoeopathic, from the Greek words " homoios" similar, and " pa- 
thos" affection — that is a " system of medicine which cures diseases 
by such agents as produce similar symptoms, when taken by an in- 
dividual in health." 

This method has been at all times unconsciously used.* Vomit- 
ing has been removed by emetics — 'diarrhoea by purgatives — the 
effects of the sun, the heat of a fire, by generous wine — the fatigue 
of dancing by tea — burns by a strong heat, instead of cold water — 
frost-bitten limbs by friction with snow.f 

Hippocrates had said that emetics cure vomiting, but it was re- 
served for the German philosopher to pursue this thought to any 
considerable extent. In 1790, he published his work called " Orga- 
non of the Healing Art," in which he dwells at large upon this new 
doctrine. One year after, he sent forth his "Materia Medica pura." 
This is a record of the various symptoms produced by the action of 
medicines on persons in health. Such is a brief account of the ori- 
gin of Homoeopathia, a system which encountering the violent op- 
position of apothecaries and doctors, has at length found its way into 
all quarters of the globe. 

Diseases have hitherto been divided according to their nature, ori- 
gin and duration. Thus they were sthenic or asthenic (excess or 
deficiency of tone,) inflammatory, bilious, mucous, nervous, — they 
were local or general, according as a part or whole of the body was 
assailed — they were acute or chronic according to their continuance. 
Homoeopathia divides diseases into acute and chronic, not so much 
in reference to their duration as to the cause of their continuance, 
which changes their nature, and requires a special consideration in 
the treatment. 

Hahnemann calls those diseases acute which are cured by the 
powers of nature alone — and those chronic which if left to them- 
selves have a constant tendency to aggravation. He regards them 

# We regard ourselves merely as a compiler of other men's views, and are 
not to be supposed as an advocate of these views. — Editor. 

t Napoleon, it is said, saved his soldiers thus amid the snows of Moscow. 



512 HOMOEOPATHY. 

as produced by an internal virus, and as capable of being cured only 
by specifics. Tbe virus producing chronic diseases according to him 
is of three kinds : the syphilitic — the sycotic — and the psoric. The 
first, if not destroyed by a specific, remains perpetually in the organ- 
ism. The second, or sycotic virus, manifests itself by excrescences 
on the surface of the body, or interior of the organs. From this virus 
spring warts, on different parts of the body — polypi of different or- 
gans, nsevi materni. Thuja occidentalis, a vegetable substance, has 
a specific action on this virus. The third virus is the psoric, or that 
of the itch. This last is the most diffused of all the rest. From 
this spring the malformations of the body, the congenital nsevi, crus- 
tae lacteae, worms, glandular swellings, rickets, preternatural defor- 
mities of the bones, chronic diarrhoeas, catarrhs, chronic ophthalmia, 
phthisis, herpetic eruptionSj biles, schirrus, cancers, dropsies, aneu- 
risms, hemorrkoids, chlorosis, nervous disorders, obstructions of the 
breasts, ulcers of the uterus, of the legs, (fee, varicose veins, leucorr 
hoeas, chronic gonorrhoeas, &c. (fee. 

CAUSES OF DISEASE. 

These are three, the predisposing, the remote, and the proximate. 
The predisposing is that state of the system by which the individual 
is disposed to contract a disease by some cause or other, which will 
have no effect upon a person not subject to such a state. The re- 
mote causes are those, the action of which on the living system de- 
termines the development of the malady. Homoeopathists keep in 
view the remote cause — it often impresses some different characteris- 
tics on the internal nature of the disease, and exacts particular con- 
siderations in the choice of the remedy designed to combat it. A 
diarrhoea for example, caused by cold ought not to be treated by the 
same remedy as one produced by a fit of colic, or unwholsome food. 
Inflammation of the brain is produced by various causes, and is 
treated by Homoeopathy by different remedies. 

The proximate cause is the change which takes place in the body 
by the action of the remote cause, and constitutes the disease itself. 
Homoeopathy confesses it is as impossible to know the proximate 
cause of disease, as to find out the cause of life in health. Thus the 
redness, the afflux of blood, the swelling of the tissue in the pleura 
and lungs, in pleurisy and pneumonia, the redness of the tunics in 
gastritis, the swelling of the liver in hepatitis, (fee. , are only the ma- 
terial productions of the malady. They are no more the proximate 
cause than the different organic changes, which we observe in post- 
mortem examinations. 

HOMOEOPATHIC MEDICINE.' 

Hahnemann believed that in order to appreciate fully the action 
of a medicine, it was necessary to make a trial of it on a healthy 



HOMOEOPATHY, 513 

person. In this manner, with the necessary precautions, it is easy 
to determine what changes were wrought by its action. In order to 
make a trial with medicines, a healthy person was chosen, and a 
small dose of the substances with which the experiment was to be 
made, was taken, and it was repeated daily, until some sensible ef- 
fect was produced. Care was taken to mark the sensations, and 
to observe in what order and under what circumstances, they were 
produced. 

The dose of the medicine was renewed as often as the effects en- 
tirely ceased. During these experiments, all impressions were avoid- 
ed, having a tendency to disturb its action, that is, highly seasoned 
dishes, violent emotions, &c. &c. The same medicine was tried on 
persons of different ages, sexes and temperaments. It was only after 
these direct investigations, undertaken for the purpose of ascertaining 
its virtues, that a medicine was employed by Homoeopathia in dis- 
ease, and took its place in the Materia Medica. The medicines 
composing the Materia Medica Homoeopathia are about two hundred 
in number. 

PREPARATION OF HOMCEOPATHIC MEDICINES. 

One grain of a medicinal substance is triturated with the third 
part of one hundred grains of pure and dry sugar of milk for a 
quarter of an hour ; to this mass, the remaining two-thirds of sugar 
of milk are then added, half at a time, and each part triturated for a 
quarter of an hour. Again, one grain of this mixture containing the 
hundredth part of a grain of the medicine is triturated with ninety- 
nine grains of fresh sugar of milk in the same manner as before, with 
the grain of the pure medicine. Every grain of this second tritura- 
tion will contain TTF.inrv °f a grain of the medicine. Another grain 
of this preparation is taken, and the trituration repeated with ninety- 
nine grains of a new portion of the sugar of milk. Every grain of 
this third preparation will contain T,TFT$\Tnre of a grain of the medi- 
cine. Now a grain of this last trituration is added to ninety-nine 
drops of alcohol, or distilled water, and strongly shaken twice. 
Every drop of this mixture contains Tttrffavt*.: 



65 



CHRONO-THERMAL SYSTEM 



The author of this system is Dr. Dickson of London. Our limits 
forbid giving any thing more than merely an outline. 

Its principal feature is the intermittency of all diseased action— 
that all diseases have their intermissions, or periods of immunity 
from suffering, more or less complete. And the remedies most suc- 
cessful in their cure are the identical agents employed in the treat- 
ment of intermittent fever — that ague is the type of all disease. Not 
that every disease is an ague and nothing more. A canoe (says 
Dickson) is the model of all sea- vessels — the type of every brig, 
barque, frigate, sloop, nautically termed ship. But a ship is a canoe 
and something more — a canoe enlarged and variously modified. 
There is unity of type, with variety of development — simplicity of 
principle with various modifications of form. The actions of life in 
health are all periodic — the actions of disease are periodic also. The 
remedies most influential in preventing the return of an ague fit are : 
quinine, arsenic, opium, prussic acid, iron, silver, copper, &c. &c. 
These are most effective when taken during the intermission. From 
the relation which their influence bears to time and temperature 
(cold and heat) they have been termed chrono-thermal — xf> ivo? time — 
£?/"* heat or temperature. The principle upon which the above 
mentioned articles cure and cause disease is one and the same, 
namely, their power of electrically altering the motive state of cer- 
tain parts of the body, and of changing at the same time their ther- 
mal conditions. These remedies are all of great efficacy ; but some 
of them more so than others, less with reference to the disorder, and 
its cause, than to the constitution, or peculiarity of system of indi- 
vidual patients. How conflicting (says the author of this system) 
are the views expressed by practitioners in reference to the effects of 
various medicines. By some, a particular remedy is extolled — by 
others it is denounced. These conflicting opinions are easily ex- 
plained. The difference of action of the same remedy at different 
times, depends upon certain electrical conditions of the brain. 
Remedies are valuable or not in proportion as they are capable of 
electrically or galvanically affecting temperature or motion — change 
in one never taking place without the other. The causes of disease 
can only affect the oody through the nervous system. No disease 



CHRONO-THERMAL SYSTEM. 515 

can arise independent of this — no disease can be cured without it. 
Let the nerves of a part be paralysed and the most potent agents 
cease to exert their wonted influence over the parts supplied by such 
nerves. Divide the pneumo-gastric nerves of a living dog, and 
arsenic loses its accustomed effect on the lungs and stomach. Is not 
this one of many proofs that an external agent can only influence 
internal parts, by means of its electric power over the nerves con- 
nected with, or leading to those parts? 

Through the same medium and in the same manner, do the 
greater number of the chrono-thermal remedies exert their salutary 
influence on the human frame. All these forces act by attraction or 
repulsion. The brain and spinal column are the nervous centres 
through which, every medicine tells, and many are the avenues 
through which, these centres may be approached. Assimilation, 
secretion, absorption, the change of the matter of one organ into 
another, of the fluids and solids, and of solids into fluids, are (says 
Dickson) operatives of vital chemistry, and the brain and nervous 
system are electric apparatus by which these operations are effected. 
Let a bone or tendon be fractured, and they are reunited by the 
result of secretion under the influence of this electricity through the 
nerves supplying those parts. 

If, during childhood, the great nerve of a limb be paralysed, the 
growth of that limb is arrested in breadth and length. Nerves are 
the moving powers, destroy them, and all vital action ceases. 

The following is a summary of all the chrono-thermal doctrines : 

1st. The phenomena of perfect health consists in a regular series 
of alternate motions, or events, each embracing a special period of 
time. | 

2d. Disease under all its modifications is in the first place, a sim- 
ple exaggeration or diminution of the amount of the same motions 
and being universally alternative with a period of comparative health, 
strictly speaking resolves itself into fever — remittent, or intermittent, 
chronic or acute — -every kind of structural disorganization, from tooth 
decay to pulmonary consumption. 

3d. The tendency to disorganization usually denominated acute 
or inflammatory, differs from the chronic or scrophulous in the mere 
amount of motion and temperature ; acute diseases being more re- 
markably distinguished by excess of both, exhibit a more rapid pro- 
gress to decomposition or cure ; while chronic diseases approach 
then srminations by less obvious alternations of the same action and 
temperature. 

The principles of the chrono-thermal system are few and simple : 

First. Fever remittent or intermittent comprehends every shade 
which disorder can assume. 

Secondly. That the treatment of every disease is to be conformed 
to that of intermittent fever. 

Thirdly. That attention to temperature is the end to all medicine. 



516 CHRONO-THERMAL SYSTEM. 

Fourthly. That blood-letting may be dispensed with in nearly all 
diseases, even in apoplexy. 

The sum of this system appears to be this : that the movements 
of all animal bodies — the greater and the less — the atomic, the func- 
tional, and the organic — whether in health or disease — disease how- 
ever caused, like all the movements of all the systems, minor and 
major of the universe at large — are equally intermittent and periodic ; 
and that there can no more be a continuous disease (that is a disease 
without an intermission) than there can be an eternal earthquake, or 
an eternal tempest. It was Samuel Dickson who first established 
the periodicity of all animal movement — that look when you will — 
above — below — beneath — around — in the tempest and whirlwind — 
on sea or land — in heaven above or on earth beneath — in animals 
and in man — in health and in disease — the face of all things bears 
the impression of this same great, uniform, universal characteristic 
of periodicity — that life in health is really a " fitful fever " — a thing 
of alternate motion and rest — alternate chill and heat, depression and 
excitement — and that intermittent fever is the model or type of all 
the movements of life, called disease — that all medicinal agents in 
nature cause, and cure by their electric influence solely — in one case 
electrically producing — in another electrically reversing every mor- 
bid, motive condition of the body — that whether opium produce sleep 
or wakefulness — whether copaivi relieve or aggravate discharges — 
that whether prussic acid or strychnine cause or relieve paralysis and 
spasms depends upon the positive or negative electrical state of the 
brain of the individual patient. Samuel Dickson was the man who 
waived his magic wand over the chaotic mass, and brought harmony 
and beauty out of disorder and confusion ! 'Twas he that first 
breathed upon the irregular and jumbled materials, and part came 
to his part — portion to kindred portion, till a beautiful array of facts 
is presented in all the symmetry and proportions of truth ! He it 
was who first touched and retouched the shapeless marble, till forth 
appeared one by one, the glowing features of the perfect statue ! # 

* In giving the above brief summary we have as much as possible confined 
ourselves to Dickson's own language. 



MATERIA MEDICA 



Life's lowest, but far greatest, sphere I sing, 

Of all things that adorn the gaudy spring ; 

Such as in deserts live, whom, unconfined, 

None but the simple laws of nature bind ; 

And those who, growing tame by human care, 

The well-bred citizens of gardens are ; 

Those that aspire to Sol, their sire's bright face, 

Or stoop into their mother Earth's embrace ; 

Such as drink streams, or wells, or those dry fed 

Who have Jove only for their Ganymede ; 

And all that Solomon's lost work of old 

(Ah! fatal loss!) so wisely did unfold. 

Though I the oak's vivacious age should live, 

I ne'er to all their names in verse could give. — Cowley. 

" How wonderful are thy works, O Lord ! in wisdom hast thou 
made them all : the earth is full of thy riches." 

In all parts of these his Glorious Works, in their admirable 
fitness to one another, and their constant subserviency to the good 
of all, we behold the Wisdom and Goodness of the Great 
Creator. 

But in no department of his works do mingled wisdom and good- 
ness shine with greater lustre than in the vegetable kingdom. There 
is scarcely a plant that greens the fields, a flower that gems the pas- 
ture, a shrub that tufts the garden, or a tree that shades the earth, 
which does not contain certain medicinal virtues, to remove our pains 
and to heal our diseases. 

The American continent, though the last found, is not the least 
favoured of God in this respect. Embracing almost every clime 
and soil of the globe, it richly abounds with drugs of every healing 
quality. 

The common saying, that every country contains the best cures 
for its own diseases, seems fully verified in America. Here, above 
all countries, is the ague, and here, exclusively, is the grand cure, 
the Peruvian bark tree, or dogwood. And here too, exclusively, is 
found the Spanish fly, the tobacco, the Jamestown weed, the pink 
and snake roots, besides those other valuable plants, equal to the 
ipecacuanha, rhubarb, jalap, &c. &c, which have hitherto been im- 



518 



MATERIA MEDICA. 



ported at a great, expense, though not always genuine ; but which 
may now be obtained in our own fields and woods, both unadulte- 
rated and cheap. 

Worthy of the high character of Americans, many gentlemen of 
the finest genius among us have explored the medical treasures of 
our country, and have shown an eagerness to make known the pre- 
cious means to preserve the health and lives of our citizens. First 
on the list of this noble band of philanthropists stood that bright lite- 
rary and professional genius, the late Professor Barton, from whose 
" Collections towards a Materia Medica of the United 
States," much valuable matter has been selected. If by the laws 
of Rome, " a civic crown was adjudged to the man who saved the 
life of a citizen," what eulogy is sufficiently great to be attached to 
the memory of him who, besides illuminating several other walks of 
ornamental and useful knowledge, has by investigating the virtues 
of our native vegetables, laid the foundation whereby millions of our 
worthy citizens may be rescued from an untimely death. 

Professor Chapman, succeeding the lamented Barton as teacher 
of Materia Medica, gave additional interest to the studies connected 
with his department, and by the application of his powerful talents 
to the acquisition of appropriate learning and discovery, has made a 
handsome accession to the stock of knowledge before extant. In 
the chair of Materia Medica, this accomplished teacher displayed 
advantageously those happy qualities which have since secured to 
him the post he now enjoys, professor of the theory and practice of 
physic, &c. 

Professor Bigelow of Harvard University, and Elliott of South 
Carolina, have since communicated to the world the results of their 
valuable scientific labours in a series of interesting lectures and ela- 
borate publications. 

Much is due also to Professors Dexter, Mitchell, Hosack, Cox, 
Baker, Caldwell, and to Doctors Mease, Cutler, Thatcher, &c. 

Prom the valuable discoveries, and communications of these gen- 
tlemen, I have, with great industry and care, compiled an Ameri- 
can Materia Medica, exhibiting, in alphabetical order, the names y 
characters, and qualities of our best medicinal plants hitherto dis- 
covered, together with the diseases they suit, and their proper doses, 
and forms of administration ; the whole stripped of technical terms, 
and making, as I humbly hope, one of the most complete systems 
for family use now extant. 



AGARIC. See Touchwood. 

AGRIMONY, Agrimonia — Grows two or three feet high, in 
hedges and the margins of fields — blossoms in July on long spikes, 



MATERIA MEDIC A. 519 

yellow. It is known by the vulgar name of cuckold, from the seeds 
sticking to the clothes in the fall of the year. 

In whey or tea it forms a good drink in fevers. The juice of this 
plant, or a strong infusion of the roots, two hands full to a quart of 
boiling water, and sweetened with honey, is an excellent medicine 
in the jaundice, scurvy, and habitual diarrhoea or looseness. Dose 
of the infusion half a pint ; of the juice a wine-glass full three times 
a-day. The herb has been applied externally to fresh wounds. 

ALDER, BLACK, Alnus Nigra — Sometimes called Virginia 
winterberry, grows in most places, generally sending up several slen- 
der stalks to the height of ten feet, and bears a red berry. 

The bark is tonic, and accordingly is used in substance, or in 
strong decoction, like the Peruvian bark, in intermittents, and other 
cases of debility, as dropsy, gangrene, &c. The inner bark in the 
shape of poultice externally, with the decoction internally, a handful 
or two boiled slowly in three pints of water to a quart, is celebrated 
both by Professor Barton and Dr. Mease, as of admirable use in 
arresting the progress of mortification. A strong decoction of the 
berries formed into a syrup with molasses in doses of a wine-glass 
full, or two tea-spoons full of the powder of the inner bark, is said to 
be a good purge. 

Dr. Thatcher recommends a decoction or infusion of the bark 
taken internally in doses of a tea-cupful, and employed also as a 
wash, for the cure of cutaneous eruptions, particularly of the her 
petic kind. 

ALEXANDER. See Parsley, Wild. 

ALUM ROOT, Heuchera Americana — Called also American 
Sanicle. The root is a very intense astringent. It is the basis of a 
powder which has lately acquired some reputation in the cure of 
cancer. Professor Barton observes that he does not believe that the 
alum root has cured genuine cancer; but that it has proved very 
beneficial in obstinate ulcers which have been mistaken for cancers. 
He says it is one of the articles in the Materia Medica of our In- 
dians, the powdered root of which they apply to wounds, ulcers, and 
cancers. 

ANGELICA, Angelica — Grows in marshy woods and hedges, 
flowering in June and July. It is frequently cultivated in our 
gardens. 

Every part of this useful vegetable partakes of its aromatic virtues, 
but especially the root, which, in the form -of powder, tincture or 
tea, is useful in flatulent colics. Conjoined with dogwood bark, or 
any other tonic, it may, like the Peruvian bark, be employed with 
advantage in intermittents and low stages of fever. The dose, one 
tea-spoonful, in substance, of the former to two of the latter. It 



520 MATERIA MEDICA. 

may also be employed in the form of strong- decoction, in doses of a 
gill, or in cold phlegmatic habits, in tincture, either alone, or with 
dogwood berries, centaury, lemon peel, or any other articles of the 
bitter and tonic class. A strong decoction of the root, combined with 
red oak bark, a large handful of each to a pint of boiling water, 
makes an admirable gargle for relaxed and spongy gums, and ulce- 
rated sore throat. 

APPLE, PERU. See Thorn Apple. 

ARBUTUS. See Bearberry. 

ARROW ROOT, Maranta Arundinacea — Is cultivated in the 
southern states. A table-spoonful makes a pint of the finest jelly in 
nature, which affords the most nutritious food in acute diseases for 
children. To persons labouring under bowel complaints, as diarrhoea 
and dysentery, it is of itself a remedy. 

The jelly is made in the following manner : — To a table-spoonful 
of the pow T dered root, add as much cold water as will make it into a 
thin paste, and then pour on boiling w T ater through the spout, of a 
kettle, stirring it at the same time briskly, till it becomes a clear 
jelly ; after which, season it w T ith sugar and nutmeg, and, to render 
it still more palatable, a little wine or lemon juice may be added. 
But, to children, blending it with new milk is best. 

AS ARAB AC C A SWAMP, Asarum— Grows in low lands. It 
has but two leaves, which rise immediately from the root, and divide 
from one stem. The flowers are purple and bell-shaped, and pro- 
ceed from between the leaves. 

The whole of this plant has a nauseous bitter taste. — The root, 
from a half to a table-spoonful in powder, operates both upwards 
and downwards. In the form of infusion, a half-handful to a quart 
of boiling water, is said to be serviceable in the whooping-cough, in 
doses of a table -spoonful to children every half hour, or oftener, un- 
til it vomits; and in doses of a tea-cupful three times a-day, it has 
been used with success to promote the menses, or courses. 

AYENS COMMON, Geum Urbanum— Grows a foot high by 
fences and borders of fields. The blossoms are w T hite or yellowish 
in July. Its smell resembles that of cloves. 

A strong tincture of the root, two hands full, steeped in a quart 
of spirits, given to the quantity of a half wine-glassful or the powder, 
in doses of a tea-spoonful, several times a-day, has afforded an ex- 
cellent remedy in intermittents and other disorders where strength- 
ening medicines are requisite. It is said to be equal to the Peruvian 
bark. 

There is another variety of this plant, called water avens, throat 
root, cure all, which is to be found in boggy meadows. The bios- 



MATERIA MEDICA. 521 

soms are purplish, and appear in May. Its properties are the same 
as the preceding. A decoction of it has been found beneficial as a 
gargle in ulcerated sore throats, which probably gave rise to the 
name of throat root, or throat wort. 

BACK-ACHE BRAKE. See Fern Female. 

BALM, Melissa Officinilas — Makes an excellent tea in fevers, 
and when sweetened, and acidulated with the juice of lemons or 
cream of tartar, forms a most grateful beverage. 

BARBERRY, Berberis Vulgaris — Grows along the sides of 
roads in hedges; — leaves oblong, tender, and subject to the rust; the 
flowers are in clusters: the fruit oblong, and acid, the stem is de- 
fended by three thorns. 

A double handful of the berries boiled in three quarts of water to 
two, and given in doses of a tea-cupful four or five times a-day, 
sweetened with white sugar, is extolled as a remedy in diarrhoea, 
dysentery, and jaundice. 

BASTARD IPECACUANHA. See Ipecacuanha American. 

BAYBERRY, Myrica Cerifera Humilis — Called also Dwarf- 
Candleberry Myrtle, grows in swamps to the height of two or three 
feet, and bears numerous green berries, of which tallow is made. 

The bark of the root has been considered a good remedy for the 
jaundice. The powder of it, in doses of twenty or thirty grains, has 
been employed as a mild emetic. The inner bark, in poultice, ap- 
plied morning and evening to scrofulous swellings, and drinking a 
tea-cupful of a strong infusion of the leaves, is said to have wrought 
surprising cures in a few weeks. 

BEARBERRY, Arbutas Uva Ursi — Bears whortleberry — wild 
cranberry. Is a low evergreen shrub, somewhat resembling the 
myrtle. 

The leaves have a bitter astringent taste, and unquestionably pos- 
sess great medical virtues, especially in relieving the irritation of the 
stone, gravel, and old cases of gonorrhoea, menstrual discharges, also 
catarrhs and consumptions. 

The dose — half a pint, twice or thrice a-day, of a decoction made 
of the leaves, a handful to a pint, or a tea-spoonful in substance, two 
or three times a-day. 

BEECH DROPS. See Broomrape Virginia. 

BENNE, Se Samum Orientate — Is now cultivated in South 
Carolina and Georgia. The leaves by infusion afford an excellent 

66 



522 MATERIA MEDTCA. 

mucilaginous drink, which is used with manifest advantage in dys- 
entery, diarrhoea, and cholera infantum. 

The seeds yield a pure and pleasant oil, which in doses from one 
to two wine-glasses full, acts well on the bowels. It is now gene- 
rally used at the tables of the wealthy, and from the specimen I had 
of it at the table of my honourable friend Governor Milledge, near 
Augusta, I consider it equal to the best Florence or salad oil. 

BETH ROOT, Trillium Rhumboydum — Grows in meadows, 
about a foot high — the leaves oval, three at the top of each stalk, 
one flower of a purple colour, bell-shaped, producing a small berry, 
that contains the seed — the root of a brown colour externally, bul- 
bous and full of small fibres. 

The powder of the root, in doses, of one tea-spoonful three or four 
times a-day, is said to be exceedingly useful in spitting of blood, im- 
moderate discbarge of the menses, or in cases of discharging bloody 
urine. It is also said to be a good application, in the form of poul- 
tice, to putrid ulcers, and to obviate gangrene or mortification. 

BIND WEED. See Potato, Wild. 

BITTER-SWEET. See Nightshade, Woody. 

BLACKBERRY, or DEWBERRY.— These, though different 
in name, are nearly, if not entirely, the same in nature. They both 
bear the same kind of berry, which, when ripe, is pleasant and 
wholesome. 

The roots of these vines, but especially of the dewberry, are fa- 
mous as astringents. From my own observation in practice, two 
hands full of the clear root in three pints of milk or water boiled to 
a quart, and given in doses of a tea-cupful every two or three hours, 
has often cured obstinate diarrhoea and dysentery, when the best 
medicines of the shop have failed. 

BLACK SNAKE ROOT. See Virginia Snake Root. 

BLAZING STAR. See Devil's Bit. 

BLOOD ROOT, Sanguinaria Canadensis — Has a variety of 
names, as Red Root, Puccoon, Indian Paint, Turmeric. It grows 
about a foot high in rich woodlands, and flowers in April. The 
leaves are roundish and deep indented; somewhat like the white oak 
leaves — stems naked, supporting single flowers ; blossoms white. 
When the fresh root, which is about the size of the little finger, 
and blood red, is broken, a juice issues in large drops resembling 
blood. 

According to Dr. Downie, the root in powder, from twenty to 
thirty grains, is strongly emetic. Professor Barton considers it nearly 



MATERIA ME DIC A. 523 

equal to the Seneca or rattle-snake root in cases of ulcerous sore 
throat, croup and hives, and other similar affections. Professor 
Dexter celebrates it in doses of one grain of the powdered root, or 
ten drops of the tincture, every two or three hours, as an excellent 
diaphoretic in colds, or pleurisies, rheumatism, and other inflamma- 
tory complaints. 

A tincture may be prepared by steeping a handful of the root 
sliced in half a pint of spirits. It may also be exhibited in the form 
of decoction, a handful to a quart of boiling water, and a table-spoon- 
ful for a dose every two or three hours. The blood root is considered 
the chief ingredient of the quack medicine known by the name of 
Rawson's bitters ; recommended as a remedy for the jaundice. The 
juice of the root is said to be good for destroying warts. 

To Professor Smith, of Hanover, N H., the world is indebted for 
the discovery that this plant, used as a powder and snuffed up the 
nose, is a certain cure for the polypus. Professor Smith also found 
it of great use in the incipient stages of pulmonary consumption, 
given in large and repeated doses, and in cases of great irritation it 
was combined with opium. 

Professor Ives, of New Haven, considers the Blood Root as a 
remedy in many diseases of the lungs and liver. He observes, that 
in typhoid pneumonia, " in plethoric constitutions, when respiration 
is very difficult, and the cheeks and hands become livid, the pulse 
full, soft, vibrating and easily compressed, the Blood Root has done 
more to obviate the symptoms and remove the disease," than any 
remedy which has been used. He infuses from a scruple to half a 
drachm of the powdered root in half a gill of hot water, and gives 
one or two tea-spoonsful every half hour, in urgent cases. This 
treatment has often removed the symptoms in a few hours. 

Dr. Ives thinks highly of its use in influenza, in consumption, and 
particularly in whooping-cough. He also states that, given in large 
doses, sufficient to produce vomiting, it often removes the croup, if 
administered in the first stages. "It has been given," he remarks, 
" for many years, in the country ; some physicians relying wholly 
on this remedy for the cure of the croup." 

Dr. Macbride of Charleston, S. C, has found the Blood Root use- 
ful in Hydrothorax, given in doses of sixty drops, thrice a-day, and 
increased till nausea followed each dose. He also used it with ad- 
vantage, in torpor of the liver, attended with colic and yellowness of 
the skin, a disease common in southern climates. 

BLOOD WORT STRIPED, Lapatkum Sanguineum Bu- 
brum — Grows six or seven inches high, on the sides of banks and 
in upland woods. Out of the top of the stalk, which is small and 
bare of leaves, grow small purple flowers, which turn into husks that 
contain the seed. The leaves, three or four in number, lie flat upon 
the ground, are hairy, and full of red winding veins; the root small, 
tough, and fibrous. 



524 MATERIA MEDICA. 

An infusion of this plant, a handful to a quart of boiling water, in 
doses of a tea-cupful every three hours, is said to be useful in re- 
straining immoderate flowing of the menses, and all other hemorr- 
hages. A strong decoction of the roots with half the quantity of 
sugar or honey, and formed into a syrup in doses of a table spoonful 
every hour or two, is beneficial in consumptions or violent coughs. 
The expressed juice, in doses of a wine glassful, and the leaves 
bruised, and frequently applied to the wound from a snake, or any 
venomous insect, is said to eradicate the poison. 

BLUE CARDINAL FLOWERS. See Lobelia. 

BONE-SET. See Thoroughwort. 

BOWMAN'S ROOT. See Indian Physic. 

BOXWOOD. See Dogwood. 

BROOMRAPE VIRGINIA, Orobanche Virginiana— Grows 
from Canada to Georgia, and rises six or eight inches high, of a 
brown colour, brittle sprigs, but no leaves ; the root is bulbous. It 
is generally found under the shade of the American beech tree, hence 
it is sometimes called beech drops, but more generally cancer root. 

Every part of this plant is considerably astringent, and along with 
the astringency, especially in the recent plant, there is combined a 
peculiar and extremely nauseous bitterness. It has been celebrated 
as a remedy in dysentery, but its principal reputation is in cancerous 
affections. It is supposed this formed part of the celebrated cancer 
powder of Dr. Hugh Martin, whose success in the management of 
many cases of this dreadful disease, has been acknowledged by the 
regular practitioners of Philadelphia. 

It is certain, says Professor Barton, that the powder of cancer root 
has been of great service, externally applied to obstinate ulcers, some 
of which had resisted all the ordinary applications. The fresh-bruised 
root has also been applied with good effects to cancerous sores. In 
the form of decoction it has been found useful as a wash to gallings 
in warm weather, or excoriation of the skin. It is also esteemed a 
good application in cases of St. Anthony's Fire. 

BUCK THORN, Spina Cervina — Grows in hedges. It is a 
prickly bush; which flowers in June, and produces in the fall a round 
black berry containing four seeds. 

Equal parts of the expressed juice of the berries and molasses, 01 
half the quantity of sugar, with a little calamus or ginger, formed 
into a syrup by a gentle fire, is said to be a good purgative medicine 
in doses of a large wine glassful, and is much used in the cure 
of dropsies. 



MATERIA MEDICA. 525 

BURDOCK, Arctium Lappa — Grows on the road-side, on rub- 
bish and ditch banks, bearing purplish blossoms in July and August, 

The juice of the fresh leaves, or an infusion or decoction of the 
roots, operates gently on the bowels, sweetens the blood, promotes 
sweat and urine, and is esteemed serviceable in scorbutic, rheumatic, 
and venereal disorders. The juice is given in doses of a wine glass- 
ful, and the decoction half a pint three times a day. 

BURNET SAXIFRAGE, Pimpinella— Grows about a foot high. 
The leaves are variously shaped, flowers in September ; the seeds 
are furred and egg-shaped. 

The root, in the form of decoction, a handful to a quart of water, 
is esteemed by some a useful medicine in asthma, coughs, and ob- 
structions of the menses, in doses of a wine glassful twice or thrice 
a-day, sweetened. 

BUTTERFLY WEED. See Pleurisy Root. 

BUTTER-NUT. See Walnut, White. 

BUTTON SNAKE ROOT.—" The button snake root grows in 
South Carolina and Georgia, in poor pine land, the root bulbous, 
with numerous fibres, of a pungent nitrous taste ; the leaves or blades 
long, narrow, pointed, and saw-edged. A stalk shoots up in autumn, 
to the height of three feet, bearing globular prickly flowers, of an ash 
colour, which, from a fancied resemblance to buttons of an old 
fashion, gives it its name. 

" This root is a powerful sudorific ; but, in cases of gangrene and 
foul ulcers, is, perhaps, superior to any thing yet discovered. The 
mode of applying it, is in the form of poultice, by boiling it soft."* 

* For the above I am indebted to my honest, but unfortunately too credulous 
friend, Paul Hamilton, Esq., formerly Secretary of the Navy, whose zeal and 
success in exploring the virtues of our indigenous plants can never be suffi- 
ciently applauded. For these and many other patriotic virtues, a kind Provi- 
dence was pleased to raise him up a son as disinterested and public spirited as 
nimself; I mean that extraordinary youth, Lieutenant Archibald Hamilton, 
who, in defence of his country, went forth in the early period of life to meet 
the veteran tars of Great Britain. 

He was a midshipman on board the United States frigate, when after a 
short action she captured the British frigate, Macedonian. His activity and 
valour in that brilliant affair were so conspicuous, that the gallant Decatur 
assigned to him the honourable and pleasing duty of bearing the British co- 
lours to the seat of government. With uncommonly good fortune he had ar- 
rived at Washington on the very evening that the President and his lady, with 
me heads of departments, at a splendid ball, were celebrating this glorious 
victory. I had the pleasure to be one of the party, and never shall I forget the 
looks of his venerable father, his most amiable mother, and charming sisters, 
when this blooming young warrior was ushered into the crowded ball room, 
with the trophies of American valour. The joy manifested on this occasion 
was not confined to his relations alone; for it was to be seen in the counte- 
nance of every one present, but more especially in the young females, who. 



526 



materia medica. 



CALICO TKEF^^Kalmia Latifolia — Broad-leafed laurel; called 
also winter green ; grows seven or eight feet high in swamps and 
moist rocky pastures ; blossoms are white, tinged with red in June 
or July. There is another species, Kalmia Augustifolia, narrow- 
leafed or dwarf laurel, called also ivy, lambkill ; blossoms reddish, 
variegated. 

A decoction of the plant externally applied has often cured the 
itch ; but, like all other poisons, it should be used with great caution. 
An ointment, made by simmering the leaves in hog's lard, is good 
for the scald head and obstinate sores. According to Dr. George G. 
Thomas, an obstinate diarrhoea has been cured, by the decoction 
made from an ounce of the leaves in half a pint of water, boiled to 
half, and thirty drops three or four times a-day. In this form it has 
also been used internally with great success in the scald head. 

CALAMUS, OR SWEET FLAG, Acorus Calamus— Grows in 
marshy situations, and in shallow water, and may be known by the 
long sword-shaped leaves, resembling those of the blue and yellow 
flags, but narrower, and of a brighter green. The root is like that 
of the blue flag in appearance, but has a strong aromatic smell, and 
a warm pungent taste. The flavour is greatly improved by drying. 

The root possesses stomach virtues, and is frequently grated into 
water, and given to children for flatulent colics, free of fever. It is 
sometimes used as an ingredient with dogwood, cherry bark, cen- 
taury, &c, in morning bitters, as a preventive of the ague in low 
marshy situations. 

CAMOMILE, Chamcsmelum — Grows well in our gardens. An 
infusion, or tea, made of the flowers, is excellent to warm and 
strengthen the stomach in cases of indigestion, loss of appetite, and 
other complaints arising from debility. It is also of great use in 
doses of a tea-cupful three times a-day, as a preventive to ague and 
fever, and bilious fever in sickly situations. In the form of fomen- 
tation and poultice it is serviceable in discussing hard tumours. 

as was very natural to suppose, from his unassuming and graceful deportment, 
could not conceal the tender emotions of their hearts. 

To the honour of the President,, this modest and amiable youth was soon 
after promoted to a lieutenancy. He followed the fortunes of Commodore 
Decatur, when he shifted his flag from the United States to the President; and 
was with this intrepid officer when in that single frigate he endeavoured to 
fight his way through a British squadron. In this most unequal conflict the 
President was overpowered, hut not until she had completely silenced one of 
the hostile frigates. By the last shot that was fired from the enemy, the gal- 
lant young Hamilton was killed. 

To say he was brave to the height of that heroism which has raised the in- 
fant navy of his country to be the admiration of the world, is to say but half 
his praise. The far nobler praise was his, of having rendered himself the idol 
of his brother officers, and his numerous relations and friends — to all of whom 
he has bequeathed the inexpressible pleasure of attaching to his memory every 
thing that was amiable and good. 



MATERIA MEDICA. 527 

CAMOMILE, WILD. See Mayweed. 

CANCER ROOT. See Broomrape Virginia. 

CANDLE-BERRY MYRTLE. See Bayberry. 

CARAWAY, Carum Carui — A choice aromatic ; grows kindly 
in our gardens. The seeds assist digestion, strengthen the stomach, 
and are serviceable in flatulent colics. The dose of the seeds in 
powder, from one to two tea-spoons full to adults. 

CARROT, WILD, Daucus Carato. — The wild carrot grows 
two or three feet high in meadows and swamps, and flowers in July. 
The seeds have an agreeable aromatic smell, and in a slight degree, 
a warm pungent taste. 

An ounce or half a handful of the seeds infused in a pint of water, 
and taken in doses of a tea-cupful every hour or two, is said to give 
immediate relief in suppression of urine, and is also serviceable in 
promoting the menses. 

The roots of the carrot cultivated in our gardens, beaten to a pulp, 
form an excellent application to cancerous and other ill-conditioned 
ulcers, allaying the pain, checking the suppuration and fetid smell, 
and softening the callous edges. A marmalade of carrots, on ac- 
count of their strong and antiseptic qualities, has been successfully 
used for preventing and curing the sea scurvy. An infusion of these 
roots has also been found useful in gravel complaints. 

CASTOR OIL, Ricinus Communis — Flourishes well among us. 

The kernels yield almost a fourth part of their weight in oil, 
which is obtained from them either by expression or decoction. 
Expression is the best method of preparing; but the common mode 
is to shell the seeds and boil them in water, and as the oil rises, to 
skim it off. 

Castor oil is a gentle and useful purgative, and is a most efficacious 
remedy for the colic or dry belly-ache, and also dysenteries, in doses 
of a wine-glassful every two or three hours until it operates. In 
doses of a tea-spoonful, it is the most suitable purge, when not ran- 
cid, to expel the meconium from new-born infants. 

CAT-GUT, or GOAT'S RUE, Galega Virginiana.—li is vul- 
garly called cat-gut, from the resemblance of some of its roots to the 
article of that name. 

A decoction of the roots is reputed to be an excellent medicine for 
destroying worms. 

CELANDINE, THE GREATER, Chelidonium Major— 

Grows about two feet high, in meadows and by running brooks, has 
many stalks, with larger joints than is common in other plants, very 
easily broken ; the leaves large and saw-edged ; the flowers, consist- 



528 



MATERIA MEDICA. 



ing of four leaves, are yellow ; after which come long pods enclosing 
black seeds ; the roots long, reddish externally, and yellow within 
and full of yellow juice. 

Twenty or thirty drops of the juice, or half a tea- spoonful of the 
dried root in powder, in a cup of new milk, morning and night, is 
said to be beneficial in dropsy, green sickness, and cutaneous erup- 
tions. The juice rubbed on warts, ring and tetter worms, effectually 
cures them. A poultice made of this plant boiled in milk, or the 
roots roasted, and mashed in vinegar, is extolled by some as an ex- 
cellent application to disperse scrofulous tumours on the neck. 

CENTAURY, Centaurium, minor — Is a fine stomach bitter, and 
either in a simple infusion, or united with calamus or angelica root, 
is excellent in relaxations of the stomach and general debility. 

CHERRY TREE, WILD, Prunus Cerasus Virginiana.— The 
bark of this tree is an excellent substitute for the Peruvian bark. I 
have myself frequently employed it in the cure of ague and fever, 
bilious fever, and other diseases where tonic medicines were proper. 
In intermittents of long standing, I have found it more efficacious 
when united with the Virginia snake root, in the proportion of one 
part of the latter to four of the former. It may be employed, either 
in powder, or decoction in the same doses as the Peruvian bark. A 
strong infusion of it in sound cider, is said to be useful in the jaun- 
dice. A decoction of the bark will be found a good wash to ill-con- 
ditioned ulcers. The cherry of the tree, when ripe in autumn, is 
much used in the southern states, for making bounce and cordial. — 
The gum of the common cherry tree is a good substitute for the 
gum Arabic. 

CHICK-WEED, RED, Annagallis Phenicea— Called also red 
pimpernel, guach-hul — is cultivated in many gardens, and grows 
spontaneously near Baltimore and Havre de Grace. 

According to the deposition of Valentine Kettiring to the Legisla- 
ture of Pennsylvania, and report made by their committee, the red 
chick-weed is a specific in that most dreadful of all diseases the 
hydrophobia, or bite of a mad dog. The dose for an adult is a small 
table-spoonful of the dried leaves in powder. For beasts the dose is 
much larger. 

CINQJJEFOIL, Potentilla Reptans — Grows on pasture grounds, 
and is something similar to strawberry. The stalks trail along the 
ground, and have but five leaves on each stalk, placed together, of 
an equal size, and bear a yellow flower. 

The whole of the plant, particularly the root, in the form of de- 
coction, a handful to a quart of water, or milk, boiled slowly, and 
sweetened with loaf sugar, is recommended as a remedy for the 
dysentery and bowel complaints. The dose for adults is a tea cup- 



MATERIA MEDIC A. 529 

ful three or four times a-day, and one third or half the quantity for 
children. 

CLEAYERS. See Goose Grass. 

COCUM. See Pokeweed. 

COCK-UP-HAT, OR YAU WEED, Stillingia—Giows on 
the high dry lands of the southern states, and is much used there as 
a cathartic medicine. It is employed in the cure of that hideous 
disease, the yaws, and is said to be a specific in the venereal disease. 

COHUSH, OR PAPOOSE ROOT, Caulophyllum Thalictro- 
ides — Grows about two feet high, in low, moist, rich grounds, near 
running streams, and on islands that have been overflowed. The 
leaves grow on small stalks near the top of the stem, which resem- 
bles the hand and fingers. The flowers are of a pale blue colour, 
which yield a berry something like grapes. The root is composed 
of many fibres, and is crooked, resembling the rattle snake root. 

An infusion of the root, a handful to a quart of boiling water, in 
doses of a tea-cupful three or four times a-day, or the same quantity 
steeped in a quart of spirits, in doses of a wine glassful twice or 
thrice a-day is highly extolled by the country people as a remedy for 
the rheumatism, and serviceable in cases of obstruction of the menses 
and dropsical complaints. 

COLT'S FOOT, Tussilago Farfara— Grows about eight inches 
high, in moist situations, producing yellow flowers, early in the spring, 
which appear before the leaves. These are soon succeeded by large 
roundish leaves, which have a bitter mucilaginous taste. 

It is said a decoction of the leaves and flowers, two hands full to 
a quart of water, with or without milk, taken freely, is serviceable 
in coughs, consumptions, diarrhoea, and dropsical complaints. The 
leaves, finely powdered, and used as snufT removes giddiness and 
obstructions of the head. 

COLUMBO AMERICAN, Columba Americana— Grows plenti- 
fully in the western country, in the vicinity of the Ohio river ; and, 
from abundant experiments, is found fully equal to the imported. 
It has long been esteemed a powerful antiseptic and tonic ; and as 
such, has been employed with manifest advantage in gangrene, 
cholera morbus, bilious vomiting, or purging, bilious fever, indiges- 
tion, want of appetite, &c. It may be given in powder, in doses of 
a small tea-spoonful every three or four hours, or in decoction, in 
doses of a tea-cupful. Two or three ounces or the root, steeped in 
a quart of spirit, forms an excellent bitter; which, when taken in 
mint water, or infusion of orange peel, in doses of a table-spoonful, 
is excellent for moderating the retching in pregnant woman. 
67 



530 MATERIA MEDICA. 

COMFREY, Consolida — Grows about two feet high in moist 
situations near springs, but is cultivated in our gardens. The leaves 
are large, similar to water dock, flowers of a pale blue colour ; the 
roots long, rather thicker than a man's finger, mucilaginous, and 
black externally, but white within. 

A handful of the roots boiled in milk, and given in doses of a tea- 
cupful three or four times a-day, is a popular remedy in dysentery, 
bowel complaints, and the fluor albus, or whites. It is also bene- 
ficial as a diet drink in the clap, or in other cases attended with a 
burning heat in making water. 

CORIANDER, Coriandrum — Is cultivated in our gardens. 

The seeds are warm, and of a pleasant flavour, and in doses of a 
tea to a table-spoonful, have been found useful in cases of indiges- 
tion and flatulence. When mixed with senna, they more effectually 
correct the odour and taste of the infusion, than any other aromatic. 
They also form an excellent addition to ingredients for bitters. 

COW PARSNIP, Heracleum Spondylium — Is found in hedges, 
meadows, and pastures ; but should be carefully distinguished from 
the hemlock or wild parsnip that grows in hedges, and is poisonous. 

According to Dr. Orne of Salem, it has been often used with success 
in epilepsy, especially in cases of indigestion with flatulence. The 
dose is three drachms of the powdered root, taken daily, and a strong 
infusion of the leaves and tops drank at bed-time. 

CRANE'S BILL, Geranium Maculatum — Improperly called by 
some crow foot. It grows five or six inches high in meadows and 
woods ; has long slender stalks, with seven long narrow leaves at a 
joint. The root is generally crooked and knotted, blackish on the 
outside, and reddish, has a rough taste, with an aromatic flavour. 

When applied externally, it is highly extolled for its styptic power, 
in stopping hemorrhages of wounded vessels. The powdered root, 
in doses of a tea-spoonful thrice or four times a-day, or a decoction 
in milk, used as a common drink, is said to be excellent in checking 
immoderate menstrual discharges, also the whites and gleets, and ob- 
stinate diarrhoea. 

The following account of the efficacy of crane's bill, as stated by 
Dr. Mease, in the Medical Museum, deserves the attention of the 
reader. 

The son of Mr, David Cooper, near Woodbury, partially divided 
the artery at the wrist with the point of a hatchet in trimming a tree ; 
the wound bled profusely, and an aneurismatic tumour of the size 
of a pullet's egg was quickly formed. Dr. Hendry, who was imme- 
diately called, applied a tourniquet, and also a piece of flat lead to 
the tumour ; and apprehending that the usual operation would be 
necessaiy, requested the assistance of Dr. William Shippen from 
Philadelphia. On the arrival of that gentleman, the operation was 



MATERIA MEDICA. 531 

resolved on ; when the father of the young man insisted upon the 
trial of a vegetable remedy, which he said he had learned the use of 
from one of the aborigines of our country. He immediately repaired 
to the woods, and returned with some of the specific, which was 
pounded in a mortar with a little cold water, and applied to the part, 
and in a short time, to the great satisfaction of the sufferer and his 
friends, checked the bleeding. The tourniquet was left on as a pre- 
cautionary measure, but fortunately no occasion offered for using it. 
In the course of a few days the wound healed, and the young man 
had no farther trouble. 

A man in pruning a tree, divided the stout muscles of the forearm 
in an oblique direction ; the wound was full four inches in length, 
and bled profusely from a large artery, and numerous smaller ves- 
sels. His shirt sleeves was filled with blood ; for being made tight 
round his wrist and forearm, it prevented the blood from escaping, 
and forming a coagulum round the bleeding orifice, checked for a 
short time farther effusion. 

The powerful effects produced by the geranium in the former case, 
induced Dr. Hendry to apply it in the present ; accordingly, he pro- 
cured some of the roots, and after washing and pounding them, filled 
the wound therewith : the effect upon the smaller vessels, was almost 
instantaneous in checking the profusion of their contents, and the 
bleeding in a short time entirely ceased ; and although, as in the 
former case, the tourniquet was \ery properly suffered to remain, yet 
no occasion offered for using it. 

Another case occurred of a wound in the ankle from a scythe, 
which had bled so profusely as to cause the man to faint ; but on the 
application of the geranium by Dr. Hendry, as above, it ceased in a 
short time. 

In the instance of a violent vomiting of blood, which had resisted 
a variety of remedies, an infusion of the plant in water, produced the 
desired effect in a few minutes. 

Another instance mentioned to me by Dr. H., of the astringent 
effect of the geranium, was that of a young man who had a most 
obstinate hemorrhage from the socket of a jaw-tooth, which had been 
extracted. An attempt was made by a physician from Philadelphia 
to close the bleeding orifice by burning it with a red hot needle, but 
without effect; on the application, however, of the geranium, the 
bleeding soon ceased. In consequence of the virtues of the gera- 
nium having been so often experienced about Woodbury in cases of 
hemorrhage, the inhabitants have been induced to cultivate the plant 
in their gardens; and it would be Avell if their example were followed 
by every one in the country; for though Providence has diffused the 
valuable plant over every part of our country, yet as it grows princi- 
pally in the woods, and the accident it is intended to relieve may 
admit of no delay, and often happens in winter, when the plant can- 
not be found, it should be transferred to every garden, that it may be 
at hand when wanted. 



532 MATERIA MEDICA. 

CROSSWORT. See Thoroughwort. 

CROW FOOT, Ranunculus Bulbosus — A very acrid plant, 
growing in meadows and fields. The leaves or roots bruised and 
applied to any part of the body, will soon raise a blister, and ought 
to be used when the Spanish flies cannot be obtained. The roots, 
collected in the fall, may be very well preserved through the winter 
by burying them in some fine dry sand. 

CUCKOLD. See Agrimony. 

CUCKOW BREAD. Set the following. 

CUCKOW PINT, Arum Maculatam— Also called lords and 
ladies, wake robin, dragon root. The leaves are generally bespan- 
gled with black and white spots, striped in gaudy style ; whence the 
country people have given it the name of lords and ladies. The 
root is bulbous, resembling a small turnip. 

Both this and the leaves, in a fresh state, are extremely acrid, and 
have been used with advantage externally for blistering, and inter- 
nally in cachexies, rheumatisms, and all other complaints of cold 
phlegmatic habits. Of the fresh root, from ten to thirty grains may 
be taken thrice a-day, in the form of emulsion, which gum Arabic, 
or cherry tree gum. The root, which should be used fresh, may be 
kept so for a year, by burying it in a cellar in sand. 

CUCUMBER ROOT, Medeola Virginica— According to Pro- 
fessor Barton, is a very common plant. The root is white, and 
tastes a good deal like the cucumber. It possesses diuretic proper 
ties, and has cured dropsies. 

CURE-ALL. See Averts. 

CURRANTS, Ribes— The white, red, and black currants, all 
grow luxuriantly in our gardens; and when perfectly ripe, and made 
with sugar and water, into the form of lemonade, serve as a most 
grateful and cooling drink in fevers. 

An infusion of the bark, sweetened with currant jelly, or honey, 
is an excellent gargle in sore throat, and an infusion of the young 
shoots is said to be beneficial in eruptive fevers. Currants afford an 
excellent wine; for making which, the following is an admirable 
recipe : — 

Of red or white currants, ripe, take fourteen pounds, broken into 
three gallons of water, and let it stand for two days, when the stalks, 
&c, will be at the top. Press off all the stalks, and, while straining 
the mixture, add twelve pounds of sugar; turn it into a cask, and 
keep it full enough to let the feculent matter work out — repeatedly 
removing it, and filling it up, until no more rise, which will be in 



MATERIA MEDICA. 533 

about fourteen days ; add to it one quart of spirits nearly tasteless, 
or else brandy, and bung up close, keeping it at least six months 
before it is bottled. Let the currants be gathered free from dew 
or rain; and if they be spread a day or two before they are used, they 
will be none the worse. Fourteen pounds will make one gallon of 
juice, twelve pounds of sugar another gallon; therefore, the above 
ingredients should be equal to five gallons, and enough to fill up with. 

CUSTARD APPLE, Annona Triloba— -It is said to be a good 
purgative medicine. 

DANDELION, Leontodon Teraxacum — Vulgarly called piss-a- 
beds, grows in meadows, pastures, and road-sides and ditch-banks, 
with yellow flowers; which blow from April to September, and pos- 
sess the remarkable quality of expanding early in the morning, and 
closing in the evening. 

The root, leaves, and stalk, contain a large proportion of bittei 
milky juice, which, in doses of a wine-glass full twice or thrice 
a-day, is good in chronic inflammations of the liver, dropsies, diffi- 
culty of making water, and other complaints arising from obstruc- 
tions of the viscera. It may also be taken in the form of a strong 
decoction, from a gill to a half-pint, twice or thrice a-day. 

DEADLY NIGHTSHADE. See Nightshade, deadly. 

DEERBERRY. See Mountain Tea. 

DEVIL'S BIT, Veratrum Luteum — The root of this plant is a 
very pungent bitter, and is employed as a tonic, either in the form 
of tincture or infusion. In this last form it has been employed as a 
vermifuge. 

DEWBERRY. See Blackberry. 

DILL, Anetheum Graveolens — Flourishes in our gardens, pro- 
ducing seed delightfully aromatic, which, in doses of one or two 
tea-spoons full, is excellent to remove flatulent colics, and assist 
digestion. 

DOCK WATER, OR WATER DOCK, Rumex Aquaticus— 
Grows in wet ditches, mill-ponds, sides of rivers, and in shallow 
water, flowering in July and August. 

Half a pint of a decoction of the leaves or roots, two hands full to 
a quart of boiling water, or two or three tea-spoons full of (he dried 
roots in powder, taken two or three times a-day, is an admirable 
medicine to sweeten and purify the blood in scurvy, scald head, 
tetter-worm, and other cutaneous diseases. The fresh roots bruised, 
and mixed with vinegar, or in strong decoction, are a good cure of 



534 MATERIA MEDICA. 

the ring-worm, and have often subdued that filthy complaint the 
itch, when quack medicines, and even sulphur, had failed. They 
are also worth trying in the form of a poultice to tumours, and 
cancerous ulcers. 

The curled dock, narrow and broad-leafed dock, which grow in 
yards and cultivated fields, are all varieties of this useful plant, and 
possess similar virtues. It is said the narrow-leafed dock, applied 
in the form of fomentation and poultice, to a cancerous sore, and 
from a pint to a quart of the decoction taken daily, makes a perfect 
cure. 

DOGWOOD, Cornus Florida.— The bark of this famous tree, 
which may well be termed the chinchona or Peruvian bark of North 
America, possesses, like that, all those tonic powers, which give it 
such admirable control over intermittents, gangrene, and all diseases 
proceeding from debility. 

From my own observation in practice I am abundantly warranted 
in pronouncing it generally preferable to the imported bark, which 
is often injured by adulteration. Like the Peruvian bark, but in 
somewhat larger doses, it may be used in substance or decoction, in- 
fusion or tincture, either alone or conjoined with snake-root, or some 
of the aromatics. But the shape in which it will be found most 
agreeable, is that of an extract ; which is easily prepared by boiling 
the bark, straining it, and then evaporating it very slowly to the 
consistence of honey. To prevent the fatal effects of burning it, the 
vessel in which it is evaporated should be of the wide-mouth sort, 
placed in a large pot of boiling water, and often stirred towards the 
close of the operation. 

The dose is from a half to a whole tea-spoonful, three or four 
times a-day. The beautiful red berries of dogwood, combined with 
lemon-peel, snake-root, calamus, or any other warm aromatic seeds, 
form a fine bitter against the common fall complaints. 

DRAGON'S CLAW. See Fever Root. 

DRAGON ROOT. See Cuckoo Pint. 

ELDER COMMON, OR BLACK, Sambucus Niger— Grows 

to the height of a small tree, in hedges, and along the border of 
meadows : the young shoots are full of pith ; and the old stalks 
empty ; flowers in July, and the berry of a blackish purple colour 
when ripe. 

The expressed juice of elder berries put into a plate, or wide- 
mouth vessel, and evaporated in the sun to the state of an extract, 
in doses from a tea to a table-spoonful, acts as a good aperient medi- 
cine. A tea made of the leaves, a large handful to a quart of boiling 
water, and taken freely, removes a costive habit, promotes perspira- 
tion, and thus proves useful in eruptions of the skin, St. Anthony's 



MATERIA MEDICA. 535 

fire, colds, dropsies, and all obstructions of the viscera. The inner 
green bark, steeped in wine, a large handful to a pint, or made into 
a strong decoction, purges gently, in doses of a gill. The flowers 
stewed with lard, form a good ointment for burns. 

Elder berries also make an excellent wine, according to the fol- 
lowing recipe : Elder wine is made by mixing twelve gallons and a 
half of ripe elder berry juice, and forty- two pounds of sugar, with 
thirty-seven gallons and a half of water, that previously has had 
boiling in it six ounces of ginger, and nine ounces of pimento, bruised 
and strained ofT; and when it has nearly cooled, rather less than 
milk warm, add a pint of thin brewer's yeast, and let it foment for 
fourteen days, in the barrel, then bung up close, and bottle in six 
months. 

ELECAMPANE, Inula Helineum — Grows three or four feet 
high, in stony pastures, and by the road-side : flowers large and 
yellow, in July and August ; and the root, when dry, has an agree- 
ble aromatic smell, and in a decoction sweetened with honey, or 
in the form of syrup, or a tea-spoonful of the powdered root in mo- 
lasses, is recommended for promoting expectoration in asthma and 
coughs. The fresh root in ointment or strong decoction, is said to 
cure the itch. 

ELM, AMERICAN, OR SLIPPERY, TJlrnus Americana— 
My very learned friend, Professor Mitchell, has witnessed its good 
effects internally in catarrhs, pleurisies, and quinsies, and externally 
as a poultice for gun-shot wounds, tumours, and all ulcers and sores 
accompanied with irritation. A tea- spoonful of the inner bark in 
powder, to a quart of boiling water, or a simple infusion of the bark 
in boiling water, forms an astonishingly rich jelly, which I have 
often tried with the happiest effects in diarrhoea and dysentery. 
With the addition of a little sugar, lemon juice, citron, or nutmeg, it 
might be made an excellent substitute for sago, or arrow root. 

I am indebted for this improvement to the reverend and very 
amiable Dr. Gant, many years chaplain to Congress, and physician 
to Mr. Jefferson. This learned gentleman, universally celebrated 
for his successful treatment of dysentery, declared to me with great 
candour, that he ascribed much of his reputation in that dangerous 
disease to this fine jelly. 

EMETIC WEED, OR INDIAN TOBACCO, Lobelia Infla- 
te* — Grows in dry fields, and rises to the height of one or two feet, 
with branched stems, flowering in July and August, with blown 
cups, filled with numerous small seeds. The blossoms are solitary, 
in a kind of spike, of a pale blue colour. The leaves are oblong, 
and have a very acrid and pungent taste, similar to that of tobacco. 

The leaves collected in August, while the plant is in blossom, and 
carefully dried and preserved, act as a speedy and excellent emetic, 



536 MATERIA MEDICA. 

in doses from ten to twenty grains ; or it may be exhibited in the 
form of a saturated tincture, in doses from a tea to a table-spoonful. 

As it is a medicine of considerable activity, it should be given in 
small quantities ; and the dose repeated every ten or fifteen minutes, 
until it excites vomiting. From its speedy operation as an emetic, 
there is no doubt it would be an effectual remedy for the croup and 
whooping-cough. In small doses it must be of great utility in con- 
sumptive and other coughs, by exciting expectoration. It is, how- 
ever, valued on account of its approaching nearer to a specific in that 
most distressing disease, the asthma, than any other that has been 
yet discovered. 

The following highly interesting observations from the Rev. Dr. 
M. Cutler, an eminent botanist, who first noticed the virtues of this 
plant, is related in Dr. Thatcher's American New Dispensatory. 

" By chewing a small portion of it, commonly not more than one 
of the capsules, it proves a gentle emetic. If the quantity be a 
little increased, it operates as an emetic, and then as cathartic, its 
effects being much the same as those of the common emetics and 
cathartics. 

" It has been my misfortune to be an asthmatic for about ten years. 
I have made trial of a great variety of the usual remedies, with very 
little benefit. In several paroxysms, I had found relief more fre- 
quently than from any thing else, from the skunk cabbage. The 
last summer I had the severest attack I ever experienced. It com- 
menced early in August, and continued about eight weeks. Dr. 
Drury, of Marblehead, also an asthmatic, had made use of a tincture 
of the Indian tobacco, by the advice of a friend, in a severe paroxysm 
early in the spring. It gave him immediate relief, and he has been 
entirely free from the complaint from that time. I had the tincture 
made of the fresh plant, and took care to have the spirit fully satu- 
rated, which, I think, is important. In a paroxysm, which was, 
perhaps, as severe as I ever experienced, the difficulty of breathing 
was extreme, and after it had continued a considerable time, I took 
a table-spoonful. In three or four minutes my breathing was as free 
as it ever was, but I felt no nausea at the stomach. In ten minutes 
I took another spoonful, which occasioned sickness. After ten 
minutes I took a third, which produced sensible effects upon the 
coats of the stomach, with moderate puking, and a kind of prickly 
sensation through the whole system, even to the extremities of the 
fingers and toes. The urinary passage was perceptibly affected with 
a smarting sensation in passing urine, which was probably provoked 
by stimulus on the bladder. But all these sensations very soon sub- 
sided, and a vigour seemed to be restored to the constitution; which 
I had not experienced for years. I have not since had a paroxysm, 
and only a few times some small symptoms of asthma. Besides the 
violent attacks, I had scarcely passed a night without more or less of 
it, and often so as not to be able to lie in bed. Since that time I 
have enjoyed as good health as perhaps before the first attack. Dr. 



MATERIA MEDICA. 537 

Cutler states a particular case has been related to him, of an effectual 
cure of the hydrophobia, or bite of a mad dog in the last stage of the 
disease, by this plant. In a disease so formidable as this, it is cer- 
tainly worthy of trial." 

Dr. Bradstreet, of Newburyport, has given the saturated tincture 
in cases of dyspepsia, also in some cases of a rheumatic nature, with 
beneficial consequences. 

He considers its sensible effects to be very like those of common 
tobacco, but its medicinal action more speedy and diffusible, and of 
shorter duration. He thinks that it affects those accustomed to the 
use of tobacco as readily as others. The active properties of the 
Lobelia are readily extracted both by water and alcohol. The tinc- 
ture, however, is most easily kept, and is the most convenient form 
for exhibition. The tincture is prepared by digesting two ounces of 
the dried plant in a pint of diluted alcohol. A tea-spoonful given to 
an adult will generally produce nausea and sometimes vomiting. 
In certain instances, however, much larger doses have been given, 
without producing any other effect than a flow of saliva. 

ERGOT, OR SPURRED RYE, Secale Cornutum.—Rye is 
subject to a disease, in low wet situations, or when a hot summer 
succeeds a rainy spring. The spurious substance called ergot, is 
found projecting from among the leaves of the spike or ear; it is a 
long crooked excrescence resembling the spur of a cock, pointed at 
the extremity, of a dark brown colour externally, and white within. 
Some spikes are occupied wholly by spurs, while others have two or 
three only, interspersed with genuine seeds of rye. 

This extraordinary substance possesses considerable medicinal pro- 
perties. In lingering and laborious cases in child-bed, it acts as an 
invaluable medicine, speedily inducing forcible pains, and expediting 
delivery. It is given in the form of powder, in doses of from five to 
fifteen grains ; but it has sometimes been found more active in the 
form of decoction, prepared by gently boiling thirty grains of the 
powder in half a pint of water, of which one-third may be taken 
every twenty minutes, until proper pains shall have commenced. 

It is proper, however, to caution the domestic practitioner against 
employing this powerful medicine in cases of preternatural presenta- 
tion, or even in every case of natural presentation. The powerful 
and continued efforts of the uterus, from the effects of the ergot, pre- 
vent the retreat of the child's head after being advanced, and (lie 
unceasing pressure, in some instances, occasioned the death of the 
child. Let this circumstance, therefore, have its due effect, and 
induce the utmost precaution in the administration of this powerful 
article. 

This medicine has also been successfully employed in cases of 
obstructed menses, or monthly evacuations. (See Thatcher's Dis- 
pensatory.) 

68 



538 MATERIA MEDICA. 

EVERGREEN CASSINE. See South Sea Tea. 

FEATHERFEW, OR FEVERFEW, Matricaria Vulgaris.— 
It is frequently cultivated in gardens. A handful of the leaves and 
tops infused in a quart of water, and given in doses of a tea-cupful 
three or four times a-day, is used by country people to promote the 
menses, to strengthen the stomach, to raise the spirits, and promote 
perspiration in colds and fevers. 

FENNEL, SWEET, Famiculum Dulce— Grows kindly in our 
gardens. A tea-spoonful of the seeds, with a little sugar and spirits, 
is a common remedy among the country people in flatulent colic. 
To children afflicted with the above complaint, an infusion of the 
seeds, sweetened, is highly serviceable. The seeds yield an aro- 
matic oil, which, in doses from two to twelve drops, removes flatu 
ience, promotes expectoration, and is serviceable in coughs. 

FERN FEMALE, OR BACKACHE BRAKE— Grows near 
ponds, and iu moist pastures, about twelve inches high. The leaves 
are single, winged, and about a hand's length ; the root is about the 
size of a goose-quill, of a brown colour, very sweet, and of a muci- 
laginous taste. 

A quart of a strong decoction of the roots, and a pint of honey, 
formed into a syrup, by gentle simmering, and given in doses of a 
table-spoonful every hour or two, is esteemed highly beneficial, in 
all violent coughs. It is said that three parts of the roots of this 
plant, and one part of sumach root, boiled slowly in any kind of 
spirits, until it becomes slimy, and then applied warm to the spine, 
has frequently relieved the backache ; hence the vulgar name back- 
ache brake. It has also been employed as a remedy for the rickets 
in children. 

FERN MALE, Polypodium — Called also sweet fern, male poly- 
pody. It grows in woods and stony places, flowering from June to 
October. 

The root, when chewed, is somewhat mucilaginous and sweet, 
and afterwards astringent and bitter. 

Sweet fern in powder, in doses from one to two tea-spoons full, 
or a decoction, a pint a-day, followed on the fifth day with a dose 
of castor oil, or some purgative medicine, is esteemed a powerful 
medicine against worms, and particularly the tape worm. 

FEVER BUSH, OR WILD ALLSPICE, Demus Febris— 
Grows in meadows and swamps, and generally rises five or six feet 
nigh, leaves numerous and somewhat spear-shaped ; the blossoms 
rather of a reddish colour ; the berries are blood red, and of a plea- 
sant smell. 

A handful of the twigs of this bush, infused in a quart of boiling 



MATERIA MEDICA. 539 

water, and given in doses of a tea-cupful every hour or two, is said 
to be extremely cooling and beneficial in fevers. 

A handful or two of the berries infused in a quart of spirits, forms 
a pleasant bitter. 

FEYER ROOT, OR DRAGON'S CLAW— Grows upon moun- 
tains and the sides of hills ; about six or seven inches high ; the 
J eaves grow in a cluster from the top of the root; spear-shaped ; 
blossoms yellow ; the root black, about the size of cloves, very ten- 
der, resembling the claws of the animal whose name it bears. 
When it is pulverised and exposed to the air, it will liquify. 

The root in the form of powder in doses of a tea-spoonful or in 
the form of decoction, a handful to a quart of water, in doses of a 
tea-cupful every hour, is esteemed an excellent medicine in bilious 
fever, pleurisy, colds, St. Anthony's Fire, and other febrile diseases. 

FIG TREE, Ficus. — This tree ought more generally to be cul- 
tivated in our gardens, as it affords a fruit both grateful to the sto- 
mach, and easy of digestion, possessing also medicinal properties. A 
decoction of figs makes an excellent gargle for cleansing the throat 
and mouth ; and the fruit, externally applied to tumours, or gum 
biles, is good to promote suppuration. When unripe, figs, as well 
as the whole tree, yield an acrid milky juice, which, if taken, proves 
both emetic and purgative, but externally is a mild caustic : hence 
it is frequently used to remove warts, ring and tetter worms. 

FLAG, BLUE, OR WATER FLAG, Iris Pseudacoris— Grows 
by the brink of rivers, in swamps and meadows, blossoming in July ; 
flowers blue, variegated with white, yellow, and purple. 

The juice, in doses of a tea-spoonful, diluted with water, is said 
to be an active cathartic medicine, and to produce copious evacua- 
tions from the bowels, and to be useful in dropsy and dysentery. It 
produces similar effects in powder, from thirty to sixty grains, and 
has been employed as a vermifuge. In the form of decoction, used 
as a diet drink, it is greatly extolled in venereal cases. 

The root of the yellow flag, mixed with the food of hogs that have 
been bitten by a mad dog, has been known to save, when without 
it others have run mad. 

FLAG, SWEET. See Calamus. 

FLAX-SEED, Linum — Possesses great medicinal virtues. An 
infusion, or tea, is the most suitable drink for patients labouring un- 
der violent colds, coughs, difficulty or burning in making water. 
The flax-seed syrup, which is prepared by adding a pint of honey to 
a quart of strong tea, and simmering it away slowly by a gentle tire 
for an hour, observing to take off the scum as it rises, I have found 
to be a most valuable medicine in diseases of the breast and lungs, 



540 MATERIA MEDICA. 

in doses from a tea to a table-spoonful every hour or two, or often er, 
when the cough is troublesome. The flax-seed bruised, also forms 
one of the best emollient poultices with which we are acquainted. 

FLEA-BANE, PHILADELPHIA, Erigeron Philadelphicum 

— Called, by some, skerish. It is said, by Professor Barton, to be a 
very common plant in many parts of the United States, and that in 
the form of infusion or decoction, it operates powerfully as a diuretic, 
and also as a sudorific. It is likewise reputed to be a good remedy 
for promoting the menstrual discharge. 

In Virginia there is a plant called pisswort, which is esteemed a 
powerful medicine in cases of strangury, or difficulty of urine. 

FLOWER DE LUCE. See Flag, Blue. 

FLUX ROOT. See Pleurisy Root. 

FOXGLOVE, Digitalis Purpurea — Has lately been cultivated 
in our gardens. It rises to the height of two or more feet, and its 
leaves are large, egg-shaped, notched like a saw, and covered with 
hairs. Blossoms of a beautiful purple colour, hanging downwards 
in a row along one side, which are compared to the fingers of a 
glove, and in the inside are elegantly mottled with spots like little 
eyes. 

The foxglove has been employed with advantage in those disor- 
ders where the frequency of the pulse requires to be abated. In the 
incipient stage of consumption, it has, b} r diminishing the circulation 
through the lungs, frequently succeeded in arresting the progress of 
the disease. It has also been advantageously employed in the 
second stage, but here it should be exhibited with the greatest pre- 
caution. The treatment of consumption with foxglove, cannot be 
more satisfactorily shown, than in the following practical remarks of 
my learned friend, Dr. John Spence, of Dumfries, Virginia, commu- 
nicated in that useful work, the New York Medical Repository : — 

" In the incipient stage of consumption, where there is considera- 
ble vigour of constitution, particularly if attended with active hemor- 
rhage from the lungs, I push the use of the digitalis cautiously, but 
freely ; that is, I try to reduce the pulse under sixty strokes in a 
minute, and maintain this depression for two or three weeks, not- 
withstanding there be occasionally considerable and distressing nau- 
sea. At the same time, I advise a milk and vegetable diet, with 
gentle exercise on horseback, or in a carriage, when the weather will 
admit, and the use of the swing-chair for an hour at a time, or twice 
or thrice a-day. When the pains about the chest are wandering, I 
also advise the repeated application of a blister, and other stimulating 
plasters, to the breast, and between the shoulders ; but if the pain 
be fixed, I prefer the introduction of a seton, as near the part affected 
as possible. My patient is also directed to drink moderately of emol- 



MATERIA MEDICA. 511 

lient teas, or tar- water, to be warmly clothed, to avoid cold and wet 
feet, and setting up late at night. All great exertions of the body, 
but particularly of the lungs, as singing, or speaking loudly, must 
also be carefully avoided. 

In the second or more advanced stage of this disease, accompanied 
with a quick pulse and great general debility, the treatment is very 
different. The foxglove must be so managed, as to lower the pulse, 
and moderate the fever, but never pushed to such an extent, as to 
excite nausea or sickness at the stomach. A little experience will 
soon enable a judicious and attentive practitioner to ascertain the 
dose adapted to his patient's constitution ; and as soon as he has 
attained this knowledge, he must be persevering in the use of the 
medicine. At this period of the disease, the patient's strength must 
never be suffered to languish. He must be supported by nutritious 
diet. Agreeably to the present manners of society, two or three 
meals are taken in the course of the day ; but this mode of eating is 
very improper with delicate constitutions, more food being generally 
eaten at such stated periods, than is necessary ; thereby causing great 
heat, accelerating the pulse, and throwing the whole system into 
commotion. The diet should be nourishing, and of easy digestion, 
such as jellies, broths, eggs boiled soft, oysters, raw or moderately 
roasted ; indeed, a bit of fowl, beef, mutton, or venison, dressed rare, 
may be taken in small quantities every two or three hours through- 
out the day. This deviation from the present fashion of eating is 
indispensable, ample nourishment being thereby thrown into the 
system without exciting irritation. At the same time I recommend 
solid food in this way, I forbid the use of spices, wine, or spirits. 
The same directions respecting topical applications and exercise, are 
equally applicable to this as the incipient stage, and particularly the 
exercise of swinging ; and care must be taken that the swing-chair 
be so constructed, that the patient may be perfectly at ease without 
being afflicted with fatigue or bodily exertion." 

Many other respectable physicians bear testimony in favour of this 
medicine in consumptive cases. Dr. Beddoes of London, considers 
the foxglove almost as infallible a remedy in consumption, as the 
Peruvian bark in intermittents. From its power of reducing the 
force of the circulation, it is esteemed likewise a valuable remedy in 
bleeding of the nose, spitting of blood, and excessive discharge of the 
menses, and also palpitation in the heart, from the passions of the 
mind, or intemperance. 

Dr. Rand, of Boston, has experienced the most decidedly good 
effects of this medicine in most of the preceding complaints. In 
one instance, haemoptoe, or spitting of blood, in a very athletic young 
man, where the discharge eluded the force of every other medicine, 
it reduced the pulse in eight hours, from one hundred to fifty pulsa- 
tions in a minute, and stopped the hemorrhage. He has also given 
the medicine with complete success in cases of mental derangement 

Foxglove possesses also diuretic power ; and has long been em- 



&42 MATERIA MEDIC A. 

})]oyed in dropsy. It unquestionably acts powerfully as a diuretic, 
or in evacuating the water in dropsy, and will be found of the great- 
est utility in every species of this disease, but more especially the 
dropsy of the breast, where there exists an increased action in the 
system. 

However, from the respectable authority of Dr. Withering, and 
the celebrated Dr. Darwin, we are assured it had been exhibited 
with the most happy effects, in cases of extreme debility, where the 
pulse was feeble, intermitting, and the countenance pale. It should 
not be given in such doses as to excite much sickness or purge, 
otherwise it will not produce its diuretic effect. The best rule for 
its administration, is to commence with the smaller doses, twice or 
thrice a-day, and gradually increase the quantity daily, until the 
medicine either act on the kidneys, the stomach or the bowels ; and 
on the first appearance of any of these effects, it is to be suspended. 

After evacuating the water, tonic or strengthening medicines 
should be employed. Dr. Currie, another physician of great emi- 
nence in England, has employed this medicine with signal advan- 
tage in inflammation of the brain, heart, and lungs, and found it 
also an excellent remedy in the inflammatory rheumatism. The 
leaves of this plant are the part in use, of which from one to three 
grains in powder, may be given to an adult twice or thrice a-day, 
alone, or united with some aromatic, or the powder may be formed 
into pills with soap, or the crumbs of bread, or it may be given in 
the form of infusion, by infusing a drachm of the dried leaves in 
half a pint of boiling water, for four hours, adding to the strained 
liquor one ounce of any spiritous water; from one to two table- 
spoons full to be given twice or thrice a-day, as a medium dose for 
an adult. Another more convenient way of ascertaining the dose 
of foxglove, is by making a saturated tincture of it in proof spirits, 
which has the twofold advantage of being invariable in its original 
strength, and of keeping a long time without losing any of its virtues. 
Put two of the leaves nicely dried, and coarsely powdered, into a 
half pint of spirits ; let it stand by the fire-side twenty-four hours or 
longer, frequently shaking the bottle, and thus making a saturated 
tincture of foxglove, which must be poured from the sediment, or 
passed through filtering paper. From twenty to sixty drops of the 
tincture may be taken in a little mint-water, or tea, two or three 
times a-day. This medicine has also been externally applied with 
good effects. An infusion of it is recommended as a good wash for 
painful cutaneous eruptions, or ulcerations. An ointment prepared 
by simmering the leaves in lard or fresh butter, has been found suc- 
cessful in scrofulous ulcers and scald head. 

FRENCH APPLE. See Thorn Apple, 

FROSTWORT, Sijstis Canadensis — Grows in woods, about two 
feet high, leaves small and numerous, of a whitish colour, like frost; 



MATERIA MEDICA. 543 

the stalk purple; flowers of a pale colour, producing a small pod with 
veiy small seed. 

It is said, in cases of scrofula, or king's evil, an infusion of the 
leaves, a handful to a quart of boiling water, in doses of a tea-cupful 
three times a-day, and the leaves in the form of a poultice, applied 
to the swelling twice a-day, has performed cures. 

FUMITORY, Fumaria Officinalis — Grows in corn-fields, and 
by fences, and rises a foot high ; leaves pale green, and the flowers 
of a reddish purple. The leaves, in the form of infusion, a handful 
to a quart of boiling water, and taken in doses of a tea-cupful thrice 
a-day, are esteemed a good medicine in scabby eruptions, and all 
cutaneous diseases, particularly if the eruptions be washed with the 
infusion. 

GARGET. See Poke Weed. 

GARLIC, COMMON, Allium Sativum — Is highly stimulating, 
and, therefore, useful to persons of cold, phlegmatic constitutions. 
It provokes the appetite, assists digestion, removes flatulence, pro- 
motes expectoration and urine ; and hence has long been used in 
scurvy, asthma, and dropsy. 

Where it cannot be taken in substance, the best form is either in 
syrup or pills. Externally applied, it blisters the skin. A poultice 
or cataplasm of equal parts of bruised garlic and crumbs of bread, 
mixed with sharp vinegar, applied to the soles of the feet, in the low 
stage, of acute disorders, or nervous fever, is good to raise the pulse, 
and relieve the head. Sydenham says it exceeds all other applica- 
tions for occasioning a revulsion from the head, and that the efficacy 
of garlic, thus applied every night, until slight inflammation be pro- 
duced, is superior to Spanish flies. It is an excellent remedy in 
cases of croup, or violent sore throat. (See Onions.) 

It will also be found a good application to the pubes in producing 
a discharge of urine, when its retention has arisen from want of due 
action of the bladder. When made into an ointment, it is said to 
disperse cold and indolent tumours, and has been esteemed for its 
efficacy in cutaneous eruptions. In deafness, a small clove of the 
root, wrapped in gauze, cotton, or wool, moistened with the juice, 
and introduced into the ear, has frequently proved an efficacious re- 
medy, if repeated twice or thrice a-day. 

GENTIAN, Gentiana — Grows on the sides of roads, and in 
waste pastures, two or three feet high. The stem is strong, smooth, 
and erect ; the leaves, which rise from the lower part of the stem, 
are spear-shaped, large, ribbed, and rough : flowers yellow, in whorls, 
terminating in yellow bitter berries. 

Its virtues are equal to the imported. It has long occupied the 
first place in all recipes for bitters, whether used to provoke the ap- 



544 MATERIA MEDICA. 

petite, or give tone to the system. It may also be taken in the form 
of infusion, a small handful of the root to a quart of boiling water, 
in doses of a tea-cupful three or four times a-day. 

In the form of a decoction, it is used with decided advantage in 
pneumonia cases, where the fever is nervous, and it acts as a tonic 
and sudorific; a tincture of it is esteemed as a remedy in dyspepsia, 
given in doses of one-fourth or half an ounce. It is said to increase 
the appetite, prevent the acidification of the food, and to enable the 
stomach to bear and digest articles of diet, which before produced 
oppression and dejection of spirits. 

GILLENIA, COMMON, Gillenia Trifoliata— Grows in woods, 
in light soil ; flowers in June and July ; and has commonly a num- 
ber of stems from the same root which are a foot or two in height, 
erect, slender, smooth, of a reddish tinge, and considerably branched. 
The leaves are alternate, and slightly toothed ; the flowers few in 
number and scattered; and the root branched and knotty. The 
root, when boiled in water, imparts to it a beautiful, deep red colour 
and an intensely bitter taste. This plant has long been known to 
practitioners as an emetic. Professor Bigelow adds his testimony of 
its possessing properties in a certain degree analogous to those of ipe- 
cacuanha. Dr. de la Motta, of Charleston, S. C, testifies to its effi- 
cacy, as an emetic both upon an empty stomach and a full one. 

Twenty or twenty -five grains, divided into four equal parts, each 
taken every fifteen minutes, are the proper dose. 

GINSENG, Panax Quinquefolium — Is thinly scattered through- 
out the mountainous regions of the northern, middle, and western 
states, between the 38th and 47th degrees of north latitude. It in- 
habits rich, shady woods, the declivities of mountains, and the banks 
of torrents. The stem is smooth, round, and green, regularly divided 
at the top into three branches, with a flower stalk in the centre. It 
flowers in July, and has red berries. The root consists of one 
or more fleshy, oblong portions, of a whitish colour transversely 
wrinkled. 

This plant is precisely the same with the Asiatic, the roots of 
which are so highly valued in China. The Chinese consider the 
ginseng as possessing unequalled medicinal powers, and their phy- 
sicians have written many volumes upon the qualities of the plant. 
It is made an ingredient in almost all remedies which they give to 
the nobility, its price being too expensive for the common people. 
The sick take it to recover health, and the healthy to make them- 
selves stronger and more vigorous. They affirm that it removes all 
fatigue, either of body or mind, dissolves humours, cures pulmonary 
diseases, strengthens the stomach, increases the vital spirits, and pro- 
longs life to old age. Its price at Pekin, according to travellers, has 
been eight or nine times its weight in silver, and even more. 

The report of the high value of the ginseng in China led to an 



MATERIA MEDICA. 545 

inquiry among Europeans, whether the plant was not to be found 
in parallel latitudes in the forests of America. Father Lafiteau, a 
Jesuit, after much search in Canada, found the plant in the year 
1717. The French and the Anglo-Americans commenced the col- 
lection of the root, and large quantities were exported. The first 
shipments to China proved extremely profitable. In a short time, 
however, the supply overstocked the market, the Chinese began to 
think the American ginseng inferior to the Tartarian, and its value 
depreciated, so that it ceased to be an object of profitable commerce. 
Its demand has not materially risen at any subsequent period, though 
it is still occasionally exported. The Chinese most readily purchase 
the forked or branching root ; and those exporters have been most 
successful who have prepared their ginseng by clarifying it after the 
Chinese manner. They dip it in scalding water, and scour it with 
a brush. The roots are then prepared with the fumes of a species 
of millet, to give them a yellow colour. The millet is put in a ves- 
sel with a little water, and boiled over a gentle fire. The roots are 
placed over the vessel upon transverse pieces of wood, being first co- 
vered with a linen cloth or another vessel. When treated in this 
way, they assume, upon drying, a horny or semi-transparent ap- 
pearance. 

The roots may also be dried in the sun, or by the fire, and retain 
their qualities perfectly. In this case, however, they have not that 
yellow colour which the Chinese so much admire. 

As far as ginseng has been tried in this country, and in Europe, 
its virtues do not appear, by any means, to justify the high estimate 
of it by the Chinese. That it is not a very active substance, is 
proved by the fact, that a whole root may be eaten without incon- 
venience. Its place in the Materia Medica is among demulcents. 

It has an agreeable taste, consisting of a mixture of sweet and 
bitter, with some aromatic pungency. Dr. Fothergill tells us that 
" in tedious chronic coughs, incident to people in years, a decoction 
of it has been of service. It consists of a lubricating mucilage, com- 
bined with some degree cf aromatic warmth." Ginseng is princi- 
cipally used as a cordial ; many persons chewing it or taking it 
steeped in wine or spirits, in doses of a wine glassful twice a-day. 
As a masticatory, ginseng is innocent and refreshing. It forms an 
excellent substitute for tobacco. I have repeatedly prescribed it to 
those whose constitutions have been injured by the immoderate use 
of tobacco, and, in every case, have witnessed the most beneficial 
consequences from its use. It is necessary, however, that the saliva 
should be swallowed. 

GOLDEN ROD, OR THREAD. See Mouth Root. 

GOOSE GRASS, Galium Aparine — Called by some Poor Ro- 
bin's plaintain, from its efficacy in curing the gravel. 

Grows in hedges, low grounds, and near brooks, to the height of 
69 



546 MATERIA MEDTCA. 

five or six feet, climbing on the bushes near it. The upper side of 
the leaves is white, with sharp prickles ; the flowers small, and di- 
vided into four segments: these change into a fruit rather large, 
composed of two berries slightly adhering together and covered with 
hooked prickles, containing two seeds. 

The leaves in the form of decoction, a handful to a quart of water, 
are highly celebrated as a remedy in gravel complaints, and suppres- 
sion of urine, in doses of a tea cup full every hour or two, until 
relieved. It has also been recommended in the cure of scurvy, spit- 
ting of blood, and epilepsy or fits. 

GROUND HOLLY, Pyrola Umbellata — It is sometimes called 
Pipsissewa, which is its Indian appellation. It possesses, in an 
eminent degree, the same properties as Bear's Whortleberry, which 
see. 

GROUND PINE, Arthetica — Grows plentifully in stony lands, 
about six inches high, sending forth many small branches, with small 
narrow grayish leaves, somewhat hairy; flowers of a pale colour, 
growing from the joint of the stalk, among the leaves, after which 
come small round husks. 

A large handful of the leaves and flowers steeped in a pint of wine, 
and taken in doses of a wine glassful twice or thrice a-day, is said to 
be beneficial in rheumatism and uterine obstructions. 

GROUND PINK, Silene Virginica— Called also catch-fly. A 
decoction of the roots is said to have been found a very efficacious 
remedy for worms. 

GUINEA PEPPER. See Pepper, Red. 

HART'S TONGUE — Grows among rocks and shady places, the 
leaves being of a shining black colour, long, pointed, and tongue 
shaped. 

This herb, in the form of infusion, a handful to a quart of boiling 
water, in doses of a tea cupful two or three times a-day, is said to be 
a good remedy in diarrhoea and dysentery ; and in the form of oint- 
ment, prepared by simmering a handful of the leaves in half a pint 
or more of lard, is a good application to scalds and burns. 

HEART'S EASE, OR HERB TRINITY, Viola Tricolor— 
Grows generally in corn-fields, producing white and yellow blossoms, 
intermixed with purple, which flower from May to September. 

A decoction of a handful of the fresh leaves, or half the quantity 
of the dried, in a pint of milk, used daily for some weeks, is said to 
be a certain remedy for that disorder in children, called milk scab, or 
that species of scald head which affects the faces of children. 



MATERIA MEDICA. 547 

HEART SNAKE ROOT— Flourishes in Carolina and Georgia, 
in rich and high lands, never exceeding the height of six inches. 
The root is of a very aromatic taste, and the smell somewhat resem- 
bling the sassafras. The leaf shaped like a heart, dark green, and 
very glossy on the upper surface. The juice of the root and leaf 
pounded together, in doses of a table-spoonful for an adult, is an 
active and safe emetic ; and a decoction in as large quantities, and as 
frequent as the stomach will bear, is of excellent service in the jail, 
camp, and nervous fever. 

HELEBORE, WHITE, Veratrum Album— Grows in wet mea- 
dows and swampy places. The stalk is thick, strong, hairy, upright, 
and usually rises from two to four feet. The leaves are large, oval, 
ribbed, plated, of a yellowish colour, and surround the stem at its 
base. The flowers are of a greenish colour, and appear from June 
to August, followed each by three flat pods, containing whitish tri- 
angular seed. The root is short, commonly near an inch thick, with 
numerous fibres hanging from it, of a brown colour externally : it 
has, when fresh, a nauseous bitter taste burning the mouth and 
fauces; and, snuffed up the nostrils in very small quanties, excites 
most violent sneezing. 

Every part of this plant is extremely acrid and poisonous. By 
the hand of skill, it has been employed internally, with beneficial 
effects, in several obstinate diseases, as those of the melancholic and 
maniacal kind, and epilepsy, king's evil, herpetic, and other cutane- 
ous affections. In these complaints, the bark of the root, collected 
in the spring, has been given in the form of powder, beginning with 
half a grain at a dose, and gradually increasing the quantity daily, 
according to its effects. 

The American species, says Dr. Thatcher, very probably possesses 
all the properties of the foreign officinal root. It is undoubtedly a 
plant of highly active powers, meriting a particular investigation as 
an article of our Materia Medica. In fact, a new interest has lately 
been excited both in Europe and the United States, relative to the 
properties of white helebore. It is even supposed to be the basis of 
the French specific remedy, called Eau Medicinale d'Husson, so 
highly famed for its almost infallible powers in the cure of the gout, 
as to command the enormous price of from one to two crowns a dose. 
This remedy was discovered about forty years ago by M. Husson, a 
French officer, who affirms it to be prepared from a plant whose vir- 
tues were before unknown in medicine ; and it has long been cele- 
brated in France, and other parts of the European continent. 

The importance and popularity of the subject were incitements to 
various attempts for that purpose, and to the ingenuity of Mr. I. 
Moore, member of the royal college of surgeons, London, the public 
are indebted for a composition, which if not identically the same 
bears a strong resemblance to the Eau Medicinale, in smell, taste, 
and dose ; and also in all its effects, as far as it has been tried in the 



548 MATERIA MEDICA. 

cure of gout. The composition of Mr. Moore consists of wine of 
opium Sydenham, one part, wine of white helebore, three parts, 
made by infusing for ten days, eight ounces of the sliced root of that 
plant, in two and a half pints of white wine, and strained through 
paper. This compound, when exhibited in doses from one to two 
drachms, has, in a variety of instances, effected a speedy cure of 
gouty paroxysms. There are, indeed, well attested facts, where the 
most painful gouty affections have yielded to a single dose of about 
one drachm ; and the instances of its failure have hitherto, it is be- 
lieved, been more rare than can be said of any other remedy. The 
employment of the composition of Mr. Moore, has also, in the hands 
of respectable physicians, been extended to acute rheumatism, and 
to some comatose affections, with the most decided advantage ; and 
a perseverance in similar trials is strongly recommended. Its opera- 
tion may be promoted by some aromatic, or peppermint, pennyroyal, 
or ginger tea. It in general occasions some nausea and vomiting, 
followed by bilious stools. Externally applied in the form of oint- 
ment or decoction, it cures the itch, and other cutaneous affections. 
An ointment is prepared by simmering the root slowty in hog's lard. 
The decoction is made by boiling two ounces or a handful of the 
root bruised, in a quart of water, to a pint and a half, and then 
strained. The addition of a few ounces of lavender, rose, or lemon 
water, may be made, if convenient. With this the parts affected 
should be washed twice or thrice a-day. 

HEMLOCK, Conium Maculatum — Grows to the height of six 
or seven feet in rich land, near ditches, and in moist shady places. 
It is an umbelliferous plant, with large leaves, of a dark green colour 
on the upper side, and a whitish green underneath ; much resem- 
bling parsley, especially the leaves of the smaller sorts, whose poison- 
ous quality is the most violent. The stalk is round, smooth, hollow, 
and marked with brown or red spots; the flowers are white; the 
seeds greenish; flat on one side, very convex, and marked with five 
fuiTows on the other. The root is long, yellowish without, white 
and fungous within, and somewhat resembling a carrot. It changes 
its form according to the season; and the leaves have a rank smell 
resembling the urine of a cat, but do not much affect the taste. 

This poisonous plant possesses great medicinal virtue when judi- 
ciously employed. It has been used with considerable advantage in 
painful cancerous ulcers, venereal ulcerations, cutaneous affections, 
gleets, painful discharges from the vagina, and in a variety of cases 
of scrofulous affections. It has also been of great efficacy in epi- 
lepsy, chronic rheumatism, and jaundice. Externally applied, it has 
been useful in discussing scirrhous tumours, particularly those of a 
scrofulous nature. 

The proper method of administering hemlock, inwardly, is to begin 
with a grain or two of the powder of the leaves, or the inspissated 
juice, and gradually to increase the dose until the head is affected 



MATERIA MEDICA. 549 

with slight giddiness, as it occasions some sickness, and trembling 
agitations of the body, or produces one or two evacuations the morn- 
ing after the dose. One or more of these symptoms are the evidences 
of a full dose, and here continue until none of these effects are ob- 
served ; and then, after a few days, increase the dose ; for little 
advantage can be expected, but by a continuance of full doses. 

The dried leaves are less liable to injury from keeping than the 
inspissated juice. The leaves should be collected in June, when 
the plant is in flower, and its peculiar smell strong. The drying of 
the leaves should be performed quickly before a fire, on tin plates. 
The proof of the drying having been well performed, is the pow- 
der's retaining the odour of the leaves, and the deepness and fresh- 
ness of the colour. It should be kept in close vials, and secluded 
from the light. 

HENBANE, BLACK, Hyosciamus Niger — Grows at the sides 
of fences, about old ruins, and on dung-hills, and with the dung is 
sometimes carried into gardens, where, from its similitude to parsnips, 
it is mistaken for them ; and w r hen eaten produces stupor and apo- 
plectic symptoms terminating in death. It rises from one to two feet 
in height; the stalks are thick, w r oody, irregularly branched, and co- 
vered with a hairy down, the leaves surrounding the stalk at their 
base, stand irregularly ; they are large, soft, and downy, pointed at 
the ends, and very deeply indented at the edges ; their colour is a 
grayish green, and they have a disagreeable smell ; the flowers are 
large, egg-shaped, and of a dirty yellowish colour, with purple streaks. 
The root is long, tough, white, and when recently cut through, 
smells like liquorice. 

According to Dr. Stork, the juice of this poisonous plant inspis- 
sated, and exhibited in doses of from one grain to twenty, every 
twenty-four hours, has relieved many from palpitation of the heart, 
a tendency to melancholy, coughs, and other spasmodic disorders 
and convulsions, and this after other means had failed. 

HERB BENNET. See Avens. 

HERB TRINITY. See Heart's Ease. 

HOGBED, OR HOGWEED, Ambrosia— Grows near farm 
yards, and on stony soils, like moss, about three inches high. The 
leaves are of a deep green colour, small and curly. The hogs de- 
light to make their bed on it, from whence it derives its name. 

A handful of this plant infused in a quart of water, and given in 
doses of a tea-cupful three or four times a-day, is a popular remedy 
among women to promote the menses or courses. 

HOLY THISTLE. See Thistle, Holy. 

HOODED WIDOW HERB, Scutellaria Lateriflora— Is found 



550 MATERIA MEDICA. 

in abundance on the banks of rivers, and the borders of ponds, flow- 
ering in July and August. The stem is square, branched, and at- 
tains the height of from one to three feet. The leaves opposite, nar- 
row pointed, on long foot stalks; the blossoms small, of a violet 
colour, intermixed with small leaves. 

Dr. Thatcher has introduced this plant in his American Dispensa- 
tory on account of its recently reputed efficacy as an antidote to ca- 
nine madness. It is directed to be given in the form of a strong in- 
fusion of the leaves every morning fasting, and to be continued 
for several weeks. For cattle, it may be mixed with their food or 
drink. 

HOPS, Humuli — Are an agreeable strong bitter, principally used 
in making malt liquors. They also induce sleep ; hence the popu- 
lar remedy of a pillow of hops to procure sleep in the delirium of 
fever and insanity, which not unfrequently succeeds. They give 
out their virtues to spirits or water. 

In the form of fomentation and poultice, hops serve as a most 
valuable application to ill-conditioned ulcers, or painful cancerous 
sores. 

Mr. Stephen Hammock, assistant surgeon to the royal hospital at 
Plymouth, gives the following account of the benefit obtained from 
the external use of hops. I have seen (says Mr. H.) very good ef- 
fects from hops in poultices and fomentations applied to ulcers of the 
worst kind, in more than sixty patients received into the hospital 
from ships of war. Some of the ulcers proceeded from scurvy, and 
some from other causes. But though all of them have been sordid, 
fetid, and extensive, yet the foetor has soon been corrected by these 
applications, and the ulcers have ceased to spread. 

A large handful of hops is to be well boiled with a quart of water, 
to which should be added meal or bran, forming a poultice, applied 
to the ulcer, without any intervening lint. But, previously to this 
application of the poultice, the ulcers are directed to be well fomen- 
ted with the decoction. The pain proceeding from the ulcers is soon 
alleviated, and the ulcers soon cease to spread. They become clean, 
and in a state to be dressed with lint, or any soft ointment. (See 
Duncan's Annals of Medicine , also Medical Repository.) 

Hops form the bases of beer and yeast, of which the following are 
the most simple, and among the most approved. 

Beer. — Take fifteen gallons of water, and boil one half of it, or as 
much as can conveniently be managed ; put the part of the water 
thus boiled, while it is yet of its full heat, to the cold part, contained 
in a barrel or cask, and then add one gallon of molasses, commonly 
called treacle, stirring them well together ; add a little yeast, if the 
vessel be new, but if it has been used for the same purpose, the yeast 
is unnecessary. Keep the bung-hole open, till the fermentation ap- 
pears to be abated, and then close it up. The beer will in a day or 



MATERIA MEDICA. 551 

two afterwards be fit to drink. A few hands full of hops, boiled in 
the water, either with a little orange peel, or without, give a whole- 
some and pleasant bitter to this beer, and assist in keeping it from 
turning sour. If tops of the spruce-fir be added to the water which 
is boiled for making this beer, it is then called spruce beer. 

Extemporaneous Small Beer. — To two quarts of common por- 
ter, add cf molasses half a pint, of ginger two drachms, water just 
warm, four quarts : let the whole ferment in a warm place, then 
rack off. 

Another. — Lemon peel one ounce, cream of tartar, four ounces, 
hops one ounce, molasses one quart, ginger one drachm, bruised 
cloves four in number, boiling water four gallons, ferment with yeast. 

To make Yeast. — Boil a pint bowl full of hops in two quarts of 
water to one quart ; put eight table-spoons full of flour into a pan, 
and su-ain the hop water boiling on it ; when mixed, it should be 
thick batter, and when milk warm, stir in it a breakfast cup of good 
yeast ; put it in three porter bottles, stopping them with paper ; put 
them into a milk-pan near the fire, and as soon as the mixture rises 
to the top of the bottle, remove them to the cellar until it subsides, 
then cork the bottles, and set them on a cool cellar floor, or in an 
ice-house. In very warm weather, the corks ought to be taken out 
every day, to let out the carbonic acid air, and the bottles again 
stopped. 

Another valuable recipe. — Boil twelve clean-washed, middle sized 
potatoes, and at the same time, boil in another vessel, a handful of 
hops in a quart of water ; peel and mash the potatoes in a mortar or 
bowl ; pour part of the hop water, while hot, upon the potatoes, mix 
them well, and pass them through a sieve, then add the remainder 
of the hop water, and half a tea-cupful of honey, beat all well, and 
add a small portion of leaven to bring on the fermentation. Put 
the whole in a stone jug, and set by the fire, in the winter ; all the 
utensils must be scalded every time they are used, and washed per- 
fectly clean. One tea-cupful of the above potato yeast, will answer 
for two quarts of flour. In summer the yeast ought to be made every 
second day. 

HOREHOUND, Marrubeum Vulgare — Grows among rubbish, 
flowering from July to September. The leaves have a very bitter 
taste. 

An infusion or tea of the leaves sweetened, is a very common 
remedy for colds. A syrup prepared by simmering slowly for an 
hour, a pint of honey in a quart of a strong decoction of the plant, 
is, from my own experience, an excellent medicine in coughs, or 
any breast complaint, in doses of a small table-spoonful every tv 



552 MATERIA MEDIC A. 

three hours, or oftener, when the cough is very troublesome. In like 
manner a candy prepared by simmering slowly half a pint of the 
juice with a pouud of sugar, will be found equally serviceable. 

In the southern states there is a plant, called wild horehound, 
growing to the height of one or two feet, of which a tea, prepared 
by adding one or two hands full of the fresh leaves, or half the 
quantity of the dried, to a quart of water, in doses of a gill or more ? 
every two or three hours, acts gently on the skin and bowels, and ks 
used like the Peruvian bark, as a tonic in the cure of ague, and 
bilious fever. 

HORSE-RADISH, Cochlearia Aimoracia — Grows on the sides 
of ditches and damp places, but is cultivated in our gardens for culi- 
nary and medicinal purposes. It has long been known as a most 
powerful antiscorbutic, and when taken freely, it stimulates the ner- 
vous system, promotes urine and perspiration, and is, therefore, use- 
fully employed in palsy, dropsy, scurvy, and chronic rheumatism. 
The root should be cut into small pieces, without bruising, and swal- 
lowed in the dose of a table-spoonful, without chewing, once or twice 
a-day, or it may be steeped in wine, and taken in doses of a small 
wine-glassful. 

Upon the authority of the celebrated Dr. Cullen, it is, in the form 
of syrup, excellent in hoarseness, or in the decline of violent colds 
and pleurisies. Whether externally or internally employed, horse- 
radish proves a stimulant ; hence it has been found serviceable by 
chewing it in palsy of the tongue, and applied in paralytic com- 
plaints to the affected parts. The root, scraped, and applied in the 
form of poultice, to the feet, until some inflammation is produced, in 
low stages of fever, attended with delirium, has also produced good 
effects. 

It is said, the root steeped in vinegar, will remove freckles of the 
face ; if so, it deserves to be tried in cases of ring or tetter worm. 

HOUSELEEK, Sempermvum — Grows on the roofs of houses 
and old walls, flowering in July. 

The juice of this plant, mixed with honey, is said to be of con- 
siderable service in the thrush of children. Stewed with cream, il 
is a great favourite with the country people for the cure of corns., 
fresh burns, stings of wasps, bees, and other external inflammations. 
An infusion of the leaves is also said to be cooling and laxative. 

HYSSOP, Hyssopus — Is cultivated in our gardens. An infusion 
of the leaves, sweetened with honey, or in the form of syrup, is use- 
ful in humoral asthma, coughs, and other disorders of the breast and 
lungs, accompanied with inflammatory symptoms. 

ICE-PLANT, Me&embryanthemum— Grows in woods te, the 



MATERIA MEDICA. 553 

height of six inches, and becomes white in September; the stalks 
and leaves are like frozen jelly, and when handled, dissolves as ice. 
The root pulverised, in doses of a half or tea-spoonful, in the 
morning, is said to be a good remedy for children troubled with fits ; 
hence it is called by the country people, Fit root. Adults may take 
it in much larger doses. 

INDIAN HEMP — Grows in woods, and on the borders of mea- 
dows, three feet high ; the stalk is bare for a root, then spring many 
branches, leaves numerous, flowers whitish, similar to buckwheat, 
which terminate in seed pods resembling a cucumber. 

The bark of the root, in the form of powder, in doses of from twen- 
ty to thirty grains, or half a tea-spoonful, will generally operate as 
an emetic and cathartic. In doses of five or six grains, or a wine- 
glassful of the infusion, every two hours, it promotes perspiration. It 
has been found beneficial in rheumatism, dropsies, and asthmatic 
complaints. A table-spoonful of the infusion, half a handful of the 
bark to a pint of boiling water, given occasionally to children in the 
whooping-cough, throws off the phlegm, and prevents straining. 

INDIAN PHYSIC, OR AMERICAN IPECACUANHA, 

Spircea Trifoleata — Grows about two or three feet high, in low 
woods and meadows. 

Professor Barton says, the root, which is the part made use of, is 
a safe and efficacious emetic. 

The celebrated Colonel Bird, of Virginia, was so enamoured of 
this plant, that he wrote a pamphlet on its virtues, which he found, 
from great and successful practice in his own very numerous family, 
to be at least equal if not superior to those of the imported ipecacu- 
anha. In the dose of thirty to forty grains in powder, for an adult, 
it is one of the most safe and certain emetics. In broken doses of 
five or six grains, every two hours, it is equally valuable as a sudo- 
rific. It may also be given in infusion, a handful to a pint of boil- 
ing water, of which a small tea-cupful may be taken every fifteen or 
twenty minutes until it promotes vomiting. 

INDIAN TOBACCO. See Emetic Weed. 

INDIAN TURNIP, Arum Triphyllum — Grows in meadows 
and sw r amps, six or eight inches high, purple stalks, leaves three in 
number, roundish, and berries of a bright scarlet colour. 

It is a very acrid plant. As ointment prepared by simmering the 
fresh root in hog's lard, and one eighth part of wax, is said to be a 
good application in the scald head. From the authority of Professor 
Barton, we learn that the recent root, boiled in milk, has been ad- 
vantageously employed in cases of consumption. He even cites a 
very striking instance. It is also recommended in the asthma, and 
whooping-cough, in the form of conserve, made of a pound of the 
70 



554 MATERIA MEDIC A. 

peeled root pounded finely in a mortar, with three pounds of loaf 
sugar ; dose, a tea-spoonful twice or thrice a- day. 

INDIGO WEED, OR WILD INDIGO Sophora Tinctoria— 
Grows in great abundance on the road-sides, and in the woods, and 
is used by travellers in the middle states to drive away the flies. 

A decoction of this plant in large doses, is said to operate power- 
fully on the stomach and bowels, but in smaller doses of a wine- 
glass full, proves a mild laxative. An infusion, or tea, is said to he 
cooling and good in fevers ; and, in the form of fomentation and 
poultice, to arrest the progress of mortification, especially if a little of 
the infusion be taken internally at the same time. An ointment 
prepared by simmering the bark of the root in cream, fresh butter, or 
lard, has been recommended as a good application to sore nipples or 
ulcers of the breast. 

IPECACUANHA, AMERICAN. See Indian Physic. 

IYY. See Calico Tree. 

JAMESTOWN, OR JIMSON WEED. See Thorn Apple. 

JERUSALEM OAK, OR WORM SEED, Chenopodium An- 
thelmenticum — Has long been employed to expel worms. One or 
two tea-spoons full of the seed with molasses or honey, are generally 
given to a child two or three years old, in the morning, on an 
empty stomach, and the dose is sometimes repeated at bed-time. It 
ought to be continued for several days. When there is an aversion 
to using it in this form, the seed may be boiled in milk, and taken in 
doses of one or two wine-glasses full, or the expressed juice of the 
plant sweetened, may be exhibited in doses of a table-spoonful. 
The oil, which is prepared from the seed, possesses the same virtue, 
and is found a more convenient form of giving the medicine. 

JUNIPER, COMMON, Juniperus Communis — An evergreen 
shrub, growing on dry barren commons, and hilly ground. 

A strong decoction, made of a handful of the tops and berries to 
a quart of boiling water, in doses of a tea-cupful three or four times 
a-day, has long been employed in dropsy, scurvy, and gravel, or dif- 
ficulty of urine. The oil of juniper possesses the same properties 
in a high degree, and imparts them to ardent spirits. The peculiar 
flavour, and well known diuretic effect of Holland gin, are owing to 
this oil. 

Hoffman found it of great use in debility of the stomach and in- 
testines, particularly in old people. The stronger preparations have 
been found useful in uterine obstructions, and in paralytic affections 
of the bladder. 



MATERIA MEDICA. 555 

LAMBKILL. See Calico Tree. 
LAUREL. See Calico Tree. 

LAVENDER THRIFT, Statice Ldmonium— Grows on the 
sea-shore, on salt marshes, flowering from July to September. The 
stem is naked, branched, and about a foot high ; the leaves long and 
pointed ; the flowers blue, and growing on long spikes on the tops of 
the branches. 

According to Dr. Hughes of Providence, and Dr. Baylies of 
Dighton, a decoction of the root has been tried with success in ap- 
thous state of fever, and ulcerous sore throat, as a most powerful an- 
tiseptic. In large doses it operates as an active emetic, and in smal- 
ler, as a strong expectorant. 

LEMON TREE, Citrus Medica— Is now cultivated in the 
southern states, and holds the first place among the cooling and an- 
tiseptic vegetables, to correct the putrid tendency of animal food in 
summer. 

The acid of lemons, from its antiseptic properties, has long been 
employed as a remedy in the scurvy. Dr. Cutbush says, from the 
commencement of our navy, it has been used on board the ships of 
war with very great success, in preventing, as well as curing, this 
disease. The fresh fruit is preferred. 

Lemon, or lime juice, diluted with water, and the addition of a 
little sugar, forming lemonade, serve as one of the most grateful be- 
verages in bilious and nervous fevers. When saturated with com- 
mon table salt, it proves a valuable medicine in dysentery, putrid 
sore throat, and remittent fever. In diarrhoea and diabetes, where 
the aliments are apt to run off in their crude state, this mixture is 
said to be a most efficacious remedy. A table-spoonful of lemon 
juice, fifteen or twenty grains of salt of tartar, or salt of wormwood, 
with the addition of a little water, swallowed in a state of efferves- 
ence, is excellent to stop nausea, and allay febrile heat. The acid 
of lemons is a common remedy against narcotic vegetable poisons, 
such as opium. 

Either of the following methods is recommended for preserving 
the juice of lemon or limes. Boil the juice after straining, and bot- 
tle it, or squeeze the fruit, put the juice and pulp into a bottle, cover 
the top with an inch of oil, cork and rosin the bottle. The juice is 
supposed to feed on the pulp. Before using the juice, the pulp and 
oil must be carefully taken out. The dried peel of lemons is a grate- 
ful aromatic, and as a stomachic generally constitutes one of the in- 
gredients of bitters. 

LETTUCE, Latuca Stativa — From the fortunate discovery and 
perseverance of the celebrated Dr. Duncan, the inspissated juice of 
the common garden lettuce is found to be but little inferior in sopo- 



556 



MATERIA MEDICA. 



rifle power to opium. In those constitutions in which opium cannot 
be employed without producing very disagreeable consequences, we 
may with safety employ, as a sedative, the lettuce opium or tincture. 
Many eminent physicians bear testimony of the good effects of this 
medicine in procuring sleep, in alleviating pain, and in allaying 
inordinate action, particularly a troublesome cough. And in no in- 
stance has it been found to produce nausea, costiveness, or irritation 
of the skin, which generally follows the use of opium or laudanum. 

The best method of obtaining the inspissated juice of lettuce in 
abundance is as follows : Let the ice-lettuce, which is considered 
best for this purpose, be planted in rows; and when the top of the 
stem is about a foot above the ground, cut off about an inch from 
the top of each plant. The milky juice immediately rises above the 
wounded surface. But it is better to cut off the tops of all the plants 
before you begin to collect. After having done this, begin to collect 
the milky juice by means of a wet sponge where the incision was 
first made, and as you go along cut off a thin cross slice from the 
stem of each plant, leaving fresh wounds. After going round the 
plants about five or six times in the way mentioned, they will cease 
to yield any more milky juice at that time. But this process may 
be repeated two or three times in a day. The milky juice collected 
in this way is to be expressed into a tea-cup, or any similar vessel. 
It soon acquires a dark brown colour, like opium obtained from the 
poppy; has all its other sensible qualities; and hence it may justly 
be distinguished by the title of lettuce opium. 

It may be administered in the form of pills, in doses from one to 
two grains. The tincture is prepared by adding one ounce of the 
extract to a pint of spirits, which may be given in doses of a tea- 
spoonful. 

Another mode of preparing the tincture is by steeping two or three 
ounces of the dried leaves and stalks in a pint of spirits, for eight or 
ten days, in a warm place, frequently shaking the vessel, j.nd then 
let it be strained through paper. 

LETTUCE, WILD, Lactuca Virosa— Grows abc ,1 four feet 
high, about hedges and the borders of meadows. It 1 as three dif- 
ferent kinds of leaves : those proceeding from the roo* are slightly 
toothed ; and those attached to the flower stalks are arrow-shaped, 
pointed, and minute ; the flowers are yellow, and small ; the leaves 
are milky, and smell like opium. 

An extract prepared from the expressed juice of the leaves, ga- 
thered when in flower, and given in doses of from five to ten grains, 
twice or thrice a-day, is said to be a powerful diuretic, and of great 
efficacy in the cure of dropsy. 

LICHEN, OR LUNGWORT, Lichen— Is a thin shell, or skin, 
which grows on the bark of the white oak tree, resembling the 
lungs, from whence it is called lungwort. 



MATERIA MEDICA. 557 

It is said to possess the same qualities as the Iceland moss, or 
lichen, so celebrated in the cure of consumption. 

An infusion, a handful to a quart of boiling water, used as a com- 
mon drink, or a strong decoction formed into syrup, with honey or 
sugar, may be taken in doses of a wine glassful three or four times 
a-day. It is also said to be a useful medicine in the whooping- 
cough. 

LIFE ROOT — Grows on the borders of meadows; about two 
feet high ; leaves large and saw-edged ; flowers yellow, and the roots 
small and fibrous. 

An infusion of this plant, a handful to a quart of boiling water, 
taken in doses of a tea cupful five or six times a-day, is said to be an 
excellent remedy for the gravel. 

LOBELIA, OR BLUE CARDINAL FLOWERS, Lobelia 

Syphilitica — Grows abundantly in the middle and southern states in 
moist grounds, and near springs; has an erect stalk three or four feet 
high ; blue flowers; a milky juice and a rank smell. 

Professor Barton says this plant was purchased from the northern 
Indians by the late Sir Wm. Johnson, as a remedy in the venereal 
disease : hence, its specific name syphilitica, He doubts, however, 
its power to cure the pox ; though, from its diuretic quality, it cer- 
tainly has been found useful in gonorrhoea or clap. He states that 
many persons in the western country, from their ignorance of botany, 
have made use of a plant which they call obelia, in the venereal 
complaint. But from the specimen he has received, he believes the 
plant to be the seratula spicata or spiked sawwort. It is a powerful 
diuretic, and there is good reason to believe that it has been found 
useful, not only in venereal complaints, but also in cases of gravel. 
Thus, ignorance sometimes leads to knowledge. 

The lobelia is generally administered in the form of a decoction, 
a handful of the root and leaves boiled slowly in three pints of water 
to a quart, of which a gill or more may be taken three times a-day. 

MADDER, WILD, Rubia Tinctorum— Is cultivated in Penn- 
sylvania and South Carolina for dyeing a fine red colour, but also 
possesses great medical powers. 

It has been highly recommended in visceral obstructions, particu- 
larly of the uterus, in coagulations of the blood induced either by 
falls or bruises, in dropsical complaints, and especially in the rickets. 
It may be given in powder from five to fifteen grains to children, 
and from half to a whole drachm three or four times a-day to adults. 
When taken internally, it possesses the remarkable quality of tinging 
the urine of a red colour, and produces similar, effects on the bones 
of animals, when eaten with their food. 

MAGNOLIA — Goes by several names, as beaver tree, swamp sas 



558 MATERIA MEDICA. 

safras, elk bark, Indian bark. It is an agreeable aromatic tonic bit- 
ter medicine. 

An infusion or decoction of the bark has been used in the ague 
and fever, and is much celebrated among the western Indians as a 
remedy in rheumatism. I am informed, from a respectable source, 
that John Dickinson, Esq., author of the celebrated Pennsylvania 
Farmer's Letters, was completely cured of a violent attack of the 
chronic rheumatism by a strong decoction of the twigs of the 
magnolia. 

The species Magnolia Grandiflora, evergreen laurel, sometimes 
called tulip tree, grows to the height of eighty feet near Savannah. 
The bark of the root of this tree is also used as a substitute for the 
Peruvian bark in intermittent fevers. The cones or seed-vessels of 
the magnolia, which is commonly called cucumber tres, has been 
advantageously used in Virginia in the form of tincture, in rheuma- 
tic complaints. 

MAIDEN HAIR, Asplenium Trichomanes — Called also milk 
waste, spleenwort — Grows on old walls, rocks, and shady stony places, 
generally to the height of seven or eight inches; leaves very fine and 
soft, and spotted underneath ; stalks of a dark purple colour ; flowers 
from May to October. Its leaves have a mucilaginous sweetish taste, 
without any peculiar odour. 

An infusion, by pouring a quart of boiling water on a handful of 
the dry herb, sweetened with honey, and taken in the quantity of a 
tea cupful every hour or two, or a spoonful in the form of syrup, is 
said to be good in tickling coughs, hoarseness, and disorders of the 
breast, proceeding from acrid humours in irregularities of the menses, 
and obstructions of the viscera. 

MALE FERN. See Fern, Male. 

MALLOW, COMMON, Malva Sijlvestris— Grows in hedges, 
footpaths, and among rubbish ; flowering from June to August. The 
leaves possess a mucilaginous sourish taste. 

A decoction of this plant is said to be useful in dysenteries and 
gravel complaints, though it is chiefly employed as an emollient 
poultice to produce suppuration. 

MANDRAKE, OR MAY APPLE, Podophyllum Peltatum— 
Grows on lows grounds, two or three feet high, leaves generally 
three, broad at the base, and terminating in a sharp point ; flowers 
yellow; the fruit resembling a lime, or small yellow apple, which is 
much admired by some. 

The root is an excellent purgative, and may be taken in doses 
from ten to thirty grains in substance, or double the quantity infused 
in a gill of water. Dr. Little, of Pennsylvania, esteems it preferable 
to jalap. The honourable Paul Hamilton, who often used it, directs 



MATERIA MEDICA. 559 

equal parts of the juice and molasses to be mixed, and a table spoon- 
ful taken every hour or two until it operates. 

The best time of gathering the mandrake, for medicinal purposes, 
is in autumn, when the leaves have turned yellow, and are about 
falling off. The Indians dry it in the shade, and powder it for use. 

MARSH TREFOIL, OR BUCK BEAN, Menyanthes Trifo- 
Uata — Is a native of Europe and of America. Spongy and boggy 
soils which are inundated at certain seasons of the year, and are 
never wholly destitute of water, are the favourite situations of this 
plant The root penetrates horizontally into the bog earth to a great 
distance, and is regularly intersected with joints at the distance of 
about half an inch from each other. The stalks are long, and from 
each of them proceed three leaves. Flowers white, tinged with red. 
The root is intensely bitter, and has long held a place in the Euro- 
pean Materia Medica, as a powerful tonic. When given in small 
doses, of about ten grains, it imparts vigour to the stomach, and 
strengthens digestion. We are told by authors that it has been em- 
ployed with advantage in intermittent and remittent fevers. Boer- 
haave, in his own case of gout, was relieved by drinking the juice 
of the plant mixed with whey. Other physicians have found it 
useful in keeping off the paroxysms of that complaint. Taken by 
infusion, it also has good effects in some cutaneous diseases of the 
herpatic or seemingly cancerous kind. 

We may regard this plant as one of our numerous vegetable bit- 
ters, which are fully equal in strength to imported articles of their 
class. 

MARSH MALLOW, Althcea Officinalis — Grows in marshes and 
wet places. The leaves have a soft woolly surface, feeling like 
velvet. The flowers are of a white pale flesh colour, and appear in 
August. 

Every part of the marsh mallow, and especially the root, when 
boiled, yields a copious mucilage, on account of which it is employed 
in emollient cataplasms or poultices, for softening and maturing hard 
tumours. It is likewise of eminent service, in the form of infusion, 
in asthma, hoarseness, dysentery, and gravel. 

MARSH ROSEMARY. See Lavender Thrift. 

MASTERWORT, Imperatoria — Grows in meadows and rich 
soils, two feet high ; leaves, three together, saw-edged, and spear- 
shaped ; flowers in June. 

The root of this plant is a warm and grateful medicine in flatu- 
lency, weakness of the stomach and bowels, and dropsical affections. 
It may be taken in the form of powder, decoction, or tincture. One 
drachm, or a tea-spoonful of the powder, in a glass of wine or spirits. 
and taken an hour before the fit, has frequently prevented the ague. 



560 MATERIA MEDICA. 

The decoction or infusion is made of one handful in a quart of boil- 
ing water, and the dose is a tea cupful three times a-day. 

MAY APPLE. See Mandrake. 

MAY WEED, OR WILD CAMOMILE, Cotula Fcetida— 
Grows about two feet high, in pastures near fences ; the flowers are 
yellow, resembling camomile flowers, and are frequently used as a 
substitute for them. 

ME Z ERE ON, Daphne Mezereum — Called also spurge laurel, 
dwarf bay. Grows plentifully in woods and shady places near the 
Ohio, and flowers in the month of February or March. The fruit 
is a berry, in which is found a single seed. The leaves are spear- 
shaped, and the flowers grow of a beautiful red or rose colour. 

The bark of the root of this plant is the part used in medicine, 
and has an extremely acrid burning taste in the mouth and fauces. 

Dr. Withering asserts that a patient who lived under extreme diffi- 
culty of swallowing for three years, was effectually cured in two 
months, by chewing the root as often as she could support its irrita- 
ting effects. The fresh root scraped, and applied to the surface of 
the skin, affords an efficacious blister — when taken internally, it 
determines to the surface, and has been found greatly serviceable in 
rheumatism and obstinate cutaneous diseases. Its principal use, 
however, is in the venereal disease, in the last stage, or when mer- 
cury has failed. It is particularly efficacious in relieving noctural 
pains, and removing venereal nodes. One gill to a half pint of the 
decoction, made of two drachms, or a handful of the bark, with an 
equal quantity of liquorice root, boiled in three pints of water to a 
quart may be taken three or four times a-day. 

MILK, OR SILK WEED, Vincetoxicum— Grows by the road- 
sides, and on sandy ground, about three feet high; the stalk square; 
leaves oval and milky ; flowers yellow, which terminate in a pod 
resembling a cucumber, filled with down, which, when ripe, is 
blown away. 

A handful of the root, boiled slowly in a quart of water for half 
an hour, and given in doses of a gill or more three or four times 
a-day, is reputed to be an effectual remedy in the cure of dropsy, 
and serviceable in catarrhs, scrofulous and rheumatic disorders, and 
gravel complaints. 

MILKWORT, COMMON, Polygala Vulgaris— Thrives in dry 
pastures, and flowers in June and July. Its roots possess an ex- 
tremely bitter taste, together with all the virtues of the American 
rattlesnake root. 

A table-spoonful of a strong decoction of the root, two hands full 
boiled slowly in three pints of water, to a quart, and taken every 



MATERIA MEDICA. 5f)l 

nour or two, promotes perspiration as well as expectoration, and has, 
therefore, been used with advantage in colds, pleurisies, and other 
disorders of the breast. 

MILTWASTE. See Maiden Hair. 

MINT. See Peppermint. 

MISLETOE OF THE OAK, Viscum— Is to be found on 
several kinds of trees. That which grows upon the oak is said to 
have cured epilepsy or fits. It is directed that the misletoe be sepa- 
rated from the oak, about the last of November, gradually dried, and 
when pulverised, confined in a bottle well corked ; to be given in 
doses of a tea-spoonful three or four times a-day, gradually increasing 
the dose according to its effects. 

MOORWORT, BROAD-LEAFED, Andromeda Mariana— 
Called wicke at the southward. A strong decoction of this plant is 
extremely useful as a wash in that disagreeable ulceration of the feet, 
which is called toe-itch, and ground itch, a very common complaint 
among the negroes and lower class of people in South Carolina and 
Georgia. 

MOTHERWORT, Leonurus Cardiaca — Grows in waste places, 
and flowers in July and August. The flowers are in thorny whorls, 
purplish within, and white on the outside ; the leaves are opposite, 
two to each whorl ; they have a strong disagreeable odour, and bitter 
taste. 

An infusion of this plant is a common domestic medicine in faint- 
ing, and disorders of the stomach. It is said to be peculiarly adapted 
to some constitutions affected with nervous and hysterical agitations; . 
and that, if taken at bed-time, procures refreshing sleep, when opium 
and laudanum had failed. 

MOUNTAIN TEA, OR DEERBERRY, Gaultheria Procum- 
bens. — It spreads very extensively over the more barren mountainous 
parts of the United States. 

A strong infusion of this plant, a large handful to a quart of boil- 
ing water, in doses of a tea-cupful three or four times a-day, is es- 
teemed useful in asthma, and for promoting the menstrual discharge. 

MOUTH ROOT, OR GOLDEN THREAD, Nigelia— Is found 
in swamps ; the stems erect and naked ; the leaves grow by threes 
at the termination of the stems ; the white solitary blossoms appear 
in May; the roots are thread-shaped, and of a bright yellow colour. 

This plant has been supposed to be efficacious, as a local applica- 
tion, in ulcerations of the mouth. Its reputation in this case is, 
71 



562 MATERIA MEDI-CA. 

however, wholly unmerited, since it possesses no astringent or stim- 
ulating quality, by which it can act on the ulcerated spots. 

As a pure tonic bitter, capable of strengthening the viscerse and 
promoting digestion, it is entitled to rank with most articles of that 
kind now in use. 

MUGWORT, OR COMMON WORMWOOD, Artemisia Ab- 
sinthium. — Grows two or three feet high, on road sides and among 
rubbish ; leaves deeply divided, pointed ; on the upper side of a deep 
green, and on the under, soft or downy; flowers small and purplish. 

An infusion, a handful of the tops to a quart of boiling water, in 
doses of a tea-cupful, or a tea-spoonful of the powdered leaves three 
or fonr times a day, is an admirable stomachic in weakness of the 
stomach, lowness of spirits, and hysterical affections. It is also said 
to be a useful medicine in difficult menstruation, in intermittents, 
jaundice, and dropsical affections. Externally it is applied in the 
form of fomentation and poultice to resist putrefaction and relieve the 
pains of bruises, as well as prevent the swelling and discoloration of 
the part. 

MULBERRY TREE, Morus, Nigra et Alba.— Its fruit has the 
common qualit)^ of all other sweet fruits, quenching thirst, abating 
heat, and proving laxative in its effects. 

A syrup made of the juice of the fruit, serves as an excellent gar- 
gle for mitigating inflammations of the throat and ulcers of the 
mouth. 

The bark of the root of the black mulberry tree, in doses of thirty 
grains, or half a tea-spoonful of the powder, or double the quantity 
infused in a gill or half a pint of boiling water, or equal parts of a 
strong decoction and molasses, formed into a syrup, in doses of a 
wine glassful, is an excellent purgative, and has been used with suc- 
cess as a vermifuge, particularly for the tapeworm. 

The fruit of the common mulberry tree, when properly fermented 
and prepared, yields a pleasant vinous liquor, known under the 
name of mulberry wine. Considerable quantities of these berries 
are likewise consumed in the cider countries, where they are mixed 
with the apples, in making a delicious beverage called mulberry ci- 
der. For this purpose, the ripest and blackest mulberries are select- 
ed, and the expressed juice is added to the cider, in such a propor- 
tion as to impart a perceptible flavour. The liquor thus acquires a 
very pleasant taste, as well as a deep red colour similar to that of the 
finest port wine, both of which continue undiminished by age. 

MULLEIN, Verbascum — The leaves, a handful to the quart of 
milk, is a common remedy in bowel complaints. 

In the form of fomentation or poultice, it is employed to relieve 
the piles, and other painful swellings ; and in a dry and pulverised 
state, to destroy fungous or proud flesh. 



MATERIA MEDICA. 563 

MUSTARD, BLACK AND WHITE, Sinapis, Nigra et Alba 
— Mustard used with our food, provokes the appetite, assists diges- 
tion, and promotes the fluid secretions, and is especially adapted to 
persons of weak stomachs, or where much acid prevails, as it acts 
upon the system generally without producing much heat. 

A table-spoonful of prepared mustard in a pint of warm water, on 
an empty stomach, operates as an emetic in nervous disorders. A 
table-spoonful of the unbruised seed, taken twice or thrice a-day, 
proves a gentle laxative, increases the urinary discharges, and is 
useful in chronic rheumatism, asthma, palsy, and dropsy. In obsti- 
nate intermittents, or ague and fever, or with persons who find the 
Peruvian bark oppressive at the stomach, a tea-spoonful of the whole 
seeds, or the flower of mustard, united with the bark or any of its 
substitutes, will very frequently succeed in the cure, when a pound 
of bark alone would not produce the desired effect. In languid con- 
stitutions, or low stages of fevers, a gill of the seeds mixed with a 
small handful of horse-radish, and infused in a quart of wine, in 
doses of a wine glassful, occasionally, is a most cordial stimulant. 

Another excellent form in which mustard may be taken, is that of 
whey. It is prepared by boiling two or three table-spoons full of the 
seeds bruised, in half a pint of milk, and as much water, till the curd 
be perfectly separated, to which a little sugar may be added, and of 
this drink, a tea-cupful may be taken three or four times a-day, in 
nervous fevers. 

The powder of the seeds, mixed with the crumbs of bread or flour, 
and formed into a poultice with sharp vinegar, is an excellent appli- 
cation to the parts affected with rheumatism, and to the soles of the 
feet, and palms of the hands, in fevers, where there is a languid cir- 
culation, or cold extremities, or in cases of delirium. 

NETTLE, STINGING, Urtica— The expressed juice of a wine 
glassful, or a decoction, one handful to a quart of boiling water, in 
doses of a tea-cupful three or four times a-day, is said to be useful in 
jaundice, asthma, consumption, and gravel complaints. It is also 
said that the flower and seeds, in doses of a drachm thrice a-day, may 
be substituted for the Peruvian bark in ague and fever. Externally, 
it has been employed in restoring excitement to paralytic limbs, and 
other cases of torpor and lethargy. It may be applied by stinging 
the part with the nettles; or the fresh leaves may be applied to the 
arms or legs. 

NIGHTSHADE, AMERICAN. See Pokeweed. 

NIGHTSHADE, DEADLY, Atropa Belladonna— Grows two 

or three feet high in hedges, among rubbish, and uncultivated places ; 
flowers dusky brown on the outside, and a dull purple within, ap- 
pearing single among the leaves in June or July ; the berries round, 
green, changing to red, and, when ripe, of a shining black. The 



564 MATERIA MEDICA. 

whole of this plant is poisonous, and children allured by its beautiful 
berries, have too often experienced their fatal effects. 

Like all other strong poisons, in the hands of skill it performs won- 
derful cures in palsy, epilepsy, melancholy, jaundice, dropsy, and 
cancer. " I have," says the great Professor Cullen, " had a cancer 
of the lip entirely cured by it." A scinhosity in a woman's breast, 
of such a kind as frequently proceed to cancer, I have found entirely 
discussed by the use of it. In the employment of this dangerous 
medicine, it is necessary to begin with very small doses. Half a 
grain of the powdered leaves or root, or two table-spoonsful of the 
infusion, prepared by infusing twenty grains in half a pint of boiling 
water, and strained after cooling, is a sufficient dose for adults to 
commence with. The dose is to be gradually increased, and repeat- 
ed daily : but as soon as any dangerous symptoms occur, its use 
ought to be suspended for some days, and afterwards resumed in 
smaller doses. Externally, the powdered leaves are applied to miti- 
gate the pain in cancerous and other ill-conditioned ulcers, and the 
leaves, in the form of poultice, to discuss scirrhous and cancerous 
tumours. 

The garden nightshade, growing also on dung-hills, with white 
flowers, odour of musk, and the berries, when ripe, of a shining black, 
possesses virtues similar to those of the deadly nightshade. 

From one to three grains of dried leaves infused in boiling water, 
and taken at bed-time, will generally induce a copious perspiration, 
increase the discharge of urine, and operate as a mild laxative on 
the following day. If after increasing the dose some visible effect be 
not produced, its farther use will not avail much. The dose is to be 
repeated every night, or every other night. In the form of poultice, 
it has abated the inflammation of the eyes, painful swellings, and 
inflammation of the venereal kind, and scrofulous and cancerous 
tumours. 

The woody nightshade, called also bitter sioeet, because it is first 
sweet, and then bitter, grows on the sides of ditches, and in moist 
hedges, climbing upon the bushes with winding, woody, but brittle 
stalks. The flowers are in clusters of a blue purple colour, appear- 
ing in June or July, and always turning against the sun. The ber- 
ries are red. 

This species is not so deleterous as the above two, and it acts more 
uniformly. Its sensible operation as a medicine, is also by sweat, 
urine, and stool, and in the form of infusion, is said to be eminently 
serviceable in acute rheumatism. It has also been found efficacious 
in jaundice, scurvy, obstruction of the menses, and in obstinate cu- 
taneous disorders. An infusion, prepared by adding a pint of boiling 
water to an ounce or half a handful of the twigs or stalks, either in 
a fresh or dried state, of which a tea-cupful or more may be taken 
morning and evening. Another form is made by steeping four 
ounces of the twigs in a pint of wine. The dose a wine glassful. In 
the form of poultice or cataplasm, it is also said to be a powerful dis- 



MATERIA MEDICA. 565 

cutient of hard tumours. For this purpose boil two or three hands 
full of the leaves in wine or vinegar, to which may be added a little 
flax-seed, and this to be applied warm to indurated or hard tumours. 
The application of the juice and leaves to cancerous sores, in some 
instances, has performed a cure. 

OAK, Quercus. — The bark of the oak possesses, in a considerable 
degree, astringent, tonic, and antiseptic properties. Hence, we can 
never be at a loss for a remedy in those diseases in which the Peru- 
vian bark has been recommended. In intermittents and low stages 
of fever, in the advanced stage of dysentery, diarrhoea, indigestion, 
and other diseases of weakness, or loss of tone in the system, I have 
myself employed internally the black and red oak bark with equal 
effects, though in rather larger doses than the Peruvian bark. Many 
cases have come under my knowledge in practice, of persons, espe- 
cially children, reduced to mere skeletons, by protracted disease, of 
bilious, nervous fever, and bowel complaints, whose stomachs would 
not retain medicine, being most wonderfully restored to the blessing 
of health by bathing in a strong decoction of oak bark not more than 
milk warm, twice a-day. 

In the year 1809, I was requested by my brother, Dr. Thomas 
Ewell, who had the superintendence of the Marine Hospital in 
Washington, to visit some of his patients in the confluent small-pox, 
which had proved fatal in several instances. 

The first case presented to my view was that of a poor sailor, in 
the last stage of this dreadful disease, and so far gone, that it was 
thought utterly useless to prescribe for him, his coffin being actually 
ordered. Reflecting, however, on the virtues of the oak bark, I did 
not myself entirely despair of his case ; and instead of passing him 
by, I ordered a bath of a strong decoction of oak bark to be prepared 
with all possible despatch, setting, at the same time, some of the 
soldiers to boil the water, while others hastened to the woods for the 
bark. When we came to immerse him in it, we found his whole 
body such a mass of corruption, from the top of his head to the soles 
of his feet, so filled with vermin, that there was no other way to 
bathe him but in a sheet. I directed him to be supplied liberally 
with milk toddy, and to repeat the bath every two or three hours. 
By persevering in this treatment for two or three weeks, gradually 
diminishing the toddy and oak bath, as his strength increased, to the 
astonishment of all the spectators, he was miraculously snatched 
from the jaws of death. 

When his sight was restored, he was much surprised to see that 
the astringent waters of the bath, had made him look, as he said, 
u as black as a negro" I am happy to add, that of several others 
in the hospital, who were treated in a similar mode, not one died. 

In farther proof of the tonic and antiseptic virtues of the oak bark. 
I beg leave to cite the following case from Professor Hart on. 

" In a case of gangrene of the foot," says this learned professor. 



566 



MATERIA MEDICA. 



"from the puncture of a nail, which came under my notice in the 
course of last summer, I gave to the patient very large quantities of 
the decoction of oak bark, at the same time that the affected pait 
was constantly kept wet with the same decoction, or with a poultice 
made of bread and milk and the bark. I cannot but ascribe the 
recovery of my patient to the use of these means, and I am imbold- 
ened to recommend the use of this cheap remedy, as one highly 
worth attention in similar cases." 

OAK POISON. See Poison, Oak. 

ONIONS, Allium Cepa — Possess similar virtues with the garlic, 
only in a less degree. The disagreeable smell which they impart to 
the breath, may be effectually obviated by eating a few leaves of 
parsley immediately after the onions. 

Onions are justly reputed an efficacious remedy in suppression of 
urine, in dropsies, and in abscess of the liver. The following ex- 
ejnplification of the virtue of onions in liver complaints, deserves the 
attention of the reader. 

Captain B. Burch, of the District of Columbia, was afflicted with 
an abscess of the liver, deemed incurable by his physicians, and see- 
ing some onions in the room, expressed a wish to eat one. Thinking 
his case desperate and no longer a matter of any consequence what 
he ate, his wife immediately gratified his appetite. After eating one 
or two onions he found himself much better, which induced him 
farther to indulge his appetite. He subsisted for several weeks en- 
tirely on onions, with only the addition of a little salt and bread ; 
and from using this diet he was restored to perfect health, and is now 
a very hearty man in his fifty-third year. This, with innumerable 
instances of a similar sort, ought to convince the young practitioner, 
that in the cure of this disease nature ought always to be consulted, 
as she seldom or never errs. 

Upon the high authority of our virtuous and able statesman, the 
honourable William H. Crawford, onions externally applied is an 
invaluable remedy in violent sore throat. This worthy patriot in- 
formed me, that one of his children being violently attacked with 
the croup, at his mansion in Georgia, a physician was sent for ; but 
before he arrived, the disease became so alarming as to threaten the 
child with immediate death, if something for its relief were not 
speedily done. Having heard that an ointment of garlic had been, 
employed with beneficial effects in sore throats, he instantly had 
some onions beaten, not having any garlic at hand, to which was 
added a small portion of hog's lard ; and with this mixture, the neck, 
breast, and back of the child were well rubbed, which, in the short 
space of one hour, relieved all the distressing symptoms. Another 
case of croup, cured by this application, came under the notice of 
Mr. Crawford last fall, as he was travelling from Georgia to the seat 
of government. A little girl, daughter of the gentleman at whose 



MATERIA MEDICA. 567 

house he tarried one night, was seized with this alarming malady , 
and on his recommending the above remedy, it was employed with 
the same happy effects. 

He also stated to me, that, while in Paris, he was afflicted with a 
very sore throat, which did not yield to the usual remedies ; he di- 
rected some onions to be beaten, and had them applied to the soles 
of his feet and legs, over which his stockings were drawn. The 
happy result was, that he had a good night's rest, and in the morn- 
ing found his throat entirely cured. He communicated the cure 
wrought on himself to a French lady who was greatly distressed with 
a sore throat, which induced her to make the experiment, and the 
fortunate result was very remarkable. 

ORANGE TREE, Citrus Aurantium — Is now cultivated in the 
southern states, and deservedly esteemed for its grateful acid juice, 
which, by quenching thirst, and diminishing heat, is of considerable 
use in febrile disorders. From its virtues to resist putrescency, it 
has always, and most deservedly, held the first place on the list of 
antiscorbutics. 

The following is a recipe for making orange wine: — Take the ex 
pressed juice of forty sour oranges, five gallons of water, and fifteen 
pounds of sugar ; boil the water and sugar for twenty minutes, skim 
constantly, and when cooled to a proper heat for fermentation, add 
the juice and outer rinds of the fruit, rasped or sheered off, putting 
all in a proper keg ; leave it open for two or three days and then 
bung it close for six months. 

PAPAW. See Custard Apple. 

PAPOOSE ROOT. See Cohush. 

PARSLEY-LEAFED YELLOW ROOT, Zanthoriza Apii- 
folia^-ls a native of the southern states. The stems reach the 
height of three feet, and are somewhat thicker than the barrel of a 
goose-quill. The root is from three to twelve inches long, and about 
the diameter of a man's little finger, sending off numerous scions, 
sometimes two feet in length, by which means it spreads considera- 
bly. The flowers appear before the leaves, very early in the spring. 

Both the stem and the root are of a bright yellow colour, and 
possess a strong and bitter taste. In medicinal virtues, it is nearly 
allied to the celebrated Columbo root. The powdered stem anil 
root, in the dose of two scruples, are highly recommended in all 
cases requiring bitter and tonic medicines.* 

* The above is the character of this plant, as given by my excellent friend, 
the late Professor Woodhouse. Friendship is often partial; but eulogy, to be 
just, must employ bright colours to paint the character of such a man as Dr. 
Woodhouse. With that rare benevolence which imparts its noblest ardour 
to friendship, he combined a genius which threw a solar radiance over the 



568 MATERIA MEDICA. 

According to Professor Barton, we have a very common plant in 
various parts of the United States, particularly- in the rich soil adja- 
cent to the Ohio and its branches, in the western parts of Virginia, 
Pennsylvania, and Kentucky, which is commonly called Yellow 
Root. He describes the root of this plant as being a very powerful 
bitter, perhaps not less so than the preceding, and very popular as a 
tonic medicine. The usual forms of administering it are powder, 
tincture, and infusion. This latter has been employed as a wash in 
inflammation of the eyes. It is supposed this is the plant which 
some of the Indians make use of to cure cancers. 

PARSLEY, WILD, Petrosellinum — Grows in meadows, and 
among rocks near the sea; stems firm, near six feet high; long, thick 
root, strong smell, acrid taste ; flowers in July, and kidney-shaped 
seed, which alone are used in medicine, as a powerful diuretic. 

A small handful of the seed, boiled in a quart of water and sweet- 
ened with honey, in doses of a tea-cupful every hour or two, is cele- 
brated as a remedy in suppression of urine, or gravel complaints. 

PEACH TREE, Amygdalus Persica — Both the flowers and 
leaves are excellent cathartics, and ought to be preserved by every 
family. A tea-spoonful of a strong infusion, sweetened, and taken 
every hour or two, will operate mildly on the bowels, without griping 
as senna does. Of the syrup, prepared by boiling slowly the juice 
of the leaves, with nearly an equal quantity of molasses, honey, or 
sugar, a table-spoonful to children, and a wine glassful to adults, 
will also prove a mild laxative medicine. I have myself witnessed 
its good effects in St. Anthony's Fire and measles, and have no 
doubt of its utility in other diseases requiring gentle laxatives. 

Two of my most intimate friends, on a visit to one of their cotton 
plantations just settled in the interior part of Georgia, and where 
there was neither medicine nor physician, were taken dangerously 
ill of the bilious fever. A good neighbour hearing they were ill, 
went to see them, and prescribed what he called " an excellent phy- 
sic" which was simply a strong infusion of peach leaves, to be taken 
in doses from a gill to a half pint every two or three hours. It ope- 
rated on the stomach, bowels, and skin ; and by persevering in the 
use of it for a few days, they were happily restored to health. 

A decoction, prepared by boiling a handful of the dried leaves in 
a quart of water to a pint and a half, and taken in doses of a tea- 
dark abyss of chemical science, besides illuminating other walks of useful 
knowledge. 

To darken the gloom of so awful a dispensation, it pleased the great FA- 
THER of LIGHTS to take into his presence another star of equal lustre 
with Dr. Woodhouse. I mean that refulgent genius, Dr. Shaw, late Professor 
ot Chemistry in the University of Maryland. The friends of an art so impor- 
tant as Chemistry, will have cause to mourn the early extinction of those 
bright luminaries. 



MATERIA MEDICA. 569 

cupful every two or three hours, is reputed, upon respectable au- 
thority, to have proved an effectual remedy in many cases of affec- 
tions of the kidneys or gravel complaints, as also in cases of voiding 
blood by urine, which had resisted the usual remedies. 

PENNYROYxlL, Mentha Pulegium — An infusion, a handful 
to a quart of boiling water, the dose a tea-cupful three times a-day, 
has long been esteemed in hysteric complaints and obstructions of 
the menses. Dr. Withering says, that the expressed juice of penny- 
royal, with a little sugar or honey, a tea-cupful every two or three 
hours, is a useful medicine in the whooping-cough. 

PEPPERMINT, Mentha Piperita— Is an excellent stomachic 
in flatulent colics, languors, hysteric cases, and vomiting. The usual 
modes of administering it, are infusion, the distilled water, and the 
essential oil. The last, united with rectified spirits of wine, forms 
the essence of peppermint, so highly esteemed. 

In nausea, cholera morbus, obstinate vomiting, and griping, pep- 
permint, infused in spirits, and applied, as hot as can be endured, to 
the stomach and bowels, will be a most valuable remedy. 

A lady of Alexandria was seized with a violent fit of the colic, 
bringing on a weakness and irritability of the stomach, with nausea 
and vomiting incessantly. Two eminent physicians sent for could 
prescribe nothing that did any service. Dr. Craik being called in, 
immediately ordered a large cataplasm of stewed mint in spirits, to 
be applied as warm as it could be borne, to the pit of the stomach 
and abdomen. It operated like a charm. The distressing nausea 
and vomiting left her, the aperient medicines were then retained, 
and the obstinate constipated state of the bowels was speedily 
removed.* 

PEPPER, RED OR CAYENNE, Capsicum Annum— Is culti- 
vated in our gardens; it is a powerful stimulant, and has been found 
beneficial in chronic rheumatism. Those who are subject to flatu- 

* To heighten my satisfaction in this cure, it was wrought by a man, of 
whom I can never think without feeling the most tender sentiments of grati- 
rude; I mean my uncle, Dr. James Craik, with whom I was then a student in 
Alexandria. 

From the double motive of •pleasure to myself and profit to others, I beg to 
sketch a short outline of Dr. Craik. 

Habits of temperance, early adopted and steadily adhered to, imparted to 
nis constitution, though naturally delicate, a degree of vigour and vivacity that 
carried him through life very pleasurably, till his eightieth year. After he 
retired from practice, he continued daily to take considerable exercise ; and 
such was his activity, that, but a short time before his death, he walked from 
his country-seat to Alexandria, a distance of eight miles! 

The virtues which adorn the husband, the parent, the friend, and the mas- 
ter, have seldom been seen to shine with more durable lustre than in Dr. Craik. 

In reward of his virtues, Heaven was pleased to distinguish him with un- 
common favours. For upwards of forty years he was honoured in an extra- 

72 



570 MATERIA MEDICA. 

lence will find benefit in using it with vegetables and soup. In 
cases of violent pain or cramp in the stomach, no medicine is supe- 
rior to a strong infusion of red pepper, one or two pods to a half pint 
of spirits, in dose of from a half to a wine glassful. It is also useful, 
both as a medicine and gargle, in putrid sore throat, when infused 
in water. Steeped in spirits and applied warm to the extremities in 
chronic rheumatism, or low stages of nervous fever, when the circu- 
lation is languid, it has produced the most happy effects. 

PINK ROOT, CAROLINA, Spigelia Maralandica— Grows 
abundantly in the southern states, and is deservedly esteemed a ver- 
mifuge, or destroyer of worms. An infusion, a handful to a quart 
of boiling water, and one or two tea-cupsful night and morning, is 
the usual form and dose. With the addition of milk and sugar, 
children will take it almost as readily as their tea. It sometimes oc- 
casions disagreeable affections of the eyes ; when this occurs, suspend 
the use of the medicine until these symptoms disappear, and then 
select from another parcel, or make tea of the tops only, as it is sup- 
posed the deleterious effects are in consequence of some other root 
being attached to it. 

Pink root is also considered a valuable medicine in fevers, as is 
verified daily, when given to children in a febrile state for a vermi- 
fuge, when no other effect has been produced than a removal of the 
fever. 

PISS WORT. See Flea Bane. 

PLANTAIN, Plantago — Has long been employed as an anti- 
dote against the bites of snakes, spiders, and other venomous insects. 
The juice, extracted from the whole of the plant, is generally given 
in doses of two table-spoonsful every hour, or oftener, until the pa- 
tient be relieved. It is sometimes given in conjunction with hore- 
hound or rue. The leaves, bruised,' are considered, by some, a good 
application to fresh wounds. 

ordinary degree, with the friendship of the great Washington, being all that 
time his companion and physician. This, however, was nothing compared to 
the happiness he enjoyed in marriage with a lady, who, for all the charms 
" of a mind-illumined face, and all the graces of truth, goodness, and harmony 
of love," never had her superior among the fairest daughters of Eve. 

" So like an angel did she spend her days, 
So like a blessed saint's, were all her ways ; 
So bland, so gentle, all her actions were, 
One would have thought her an immortal here." 

After more than fifty years of the happiest life, Dr. Craik was removed to 
those scenes where bliss immortal reigns. But their separation was short. 

He first deceased, she for a few months tried 

To live without him — liked it not, and died. — Heath. 



MATERIA MEDICA. 571 

PLEURISY ROOT, Asclejpias Decumbens — Has a variety of 
names, as butterfly weed, flux root, decumbent swallow wort. It is 
a beautiful plant, growing two or three feet high, under fences and 
upland pastures. The flowers are of a bright orange colour, and ap- 
pear in July and August. These are succeeded by long slender 
pods containing the seed, which have a delicate kind of silk attached 
to them. The root is spindle or carrot-shaped, of a light brownish 
colour on the outside, white within. 

This plant possesses great medicinal virtues, and ought, therefore, 
to be cultivated in our gardens. It has long been employed as a 
remedy in the treatment of violent cold and pleurisies. No medi- 
cine is better calculated than this to produce general and plentiful 
perspiration without heating the body, and hence its well merited 
fame in curing the disease, which name it bears. Mr. Thompson 
Mason of Virginia, was among the first who noticed the virtues of 
this plant, and from his long experience of its utility in pleurisy, re- 
commended it as a specific. He states, that after the use of an eme- 
tic, and the loss of some blood, in the incipient stage, he adminis- 
tered, of the pleurisy root, finely powdered, as much as would lie 
upon the point of a case-knife, in a cup of warm water, and repeated 
the dose every two hours until the patient recovered, which happened 
frequently in a very few days. By these simple means Mr. M. cured 
great numbers. 

We have, also, many of the most respectable physicians celebra- 
ting its virtues in pleurisy, and other recent affections of the breast. 
A tea-cupful of a strong infusion, a handful to a quart of boiling wa- 
ter, is given every two or three hours. Professor Barton says the 
root of this plant in powder possesses a purgative quality, and that 
he has used it with advantage in dysentery. In Virginia also it has 
been used with great effect in this complaint. This root is fre- 
quently resorted to by country people for the relief of pains of the 
stomach from flatulence and indigestion ; hence it is called, by some, 
wind-root. 

The late Paul Hamilton, Esq., ascribed the same virtues of curing 
pleurisies and dysentery to a plant that grows in South Carolina, and 
which is also called Pleurisy Root, Asclepias Erectas. He thus 
describes it : — 

It grows in rich high lands. The root has the appearance and 
taste of a small, long, sweet potato ; the stalk erect ; the leaves re- 
sembling the persimmon leaf, is situated transversely, and when bro- 
ken, it throws out a viscid milk; blossoms in May and June. The 
blossoms are a cream colour, with purple centres. Twenty grains 
of this root in powder, he says, given in warm water or tea, is excel- 
lent in flatulent colic; and the same quantity repeated every two 
hours, in pleurisy, will seldom fail to bring on a perspiration, while 
the pectoral effects are admirable. 

POISON OAK, Rhus Toxicodendron — Embraces several spe- 



572 MATERIA MEDICA. 

cies, the most dangerous of which is the swamp sumac. The poi- 
son may be communicated, not only by the touch, but also by the 
smoke, smell, or steam producing an eruption on the skin, with pain 
and itching, and sometimes attended with swollen head and fever. 
One of the best remedies which has come under my notice, is a 
wash of crude sal ammoniac and corrosive sublimate, two drachms 
of the former to one of the latter, in a quart of water ; used exter- 
nally twice or thrice a-day; with a dose or two of salts, or an infu- 
sion of senna and salts. — I have lately been informed, from a source 
which can be relied on, that lime-water excels any other applica- 
tion as a wash in this distressing affection of the skin. The species 
called sometimes poison wood, has a low shrubby stalk, the leaves 
somewhat heart-shaped, the flowers small, the berries round, and of 
a yellow gray colour when ripe. Dr. Anderson, of Hull, has em- 
ployed the leaves of this species in doses from half a grain to four 
grains, three times a-day, with success in paralytic cases. 

Poison vine, called also poison creeper, has a slender stem, and 
frequently climbs to the top of our tallest trees. The flowers, which 
appear in June, are small, of a light yellow colour, and have a de- 
lightful odour. An extract of the leaves, two grains to a dose, and 
increased, has been successfully employed in paralytic affections, as 
w T ell as an infusion in tetter- worm and scald head. 

Professor Barton says, that a decoction has been used with seem- 
ing advantage in cases of consumption; and others say, that a decoc- 
tion of the root is serviceable in asthma. 

POKE WEED, Phytolacca Decandra — Is known by a variety 
of names, as American nightshade, coacum, garget, skoke. The 
berries, steeped in spirits, have long been employed in the chronic 
rheumatism. It has, however, sometimes failed, which may have 
been owing to the peculiarity of constitution, or to the inertness of 
the bounce or tincture from age, an effect often observed by Professor 
Barton, as also by myself. From the authority of this learned pro- 
fessor, the juice of the ripe berries, inspissated to the state of an 
extract, and spread upon a rag, or upon the leaf of the plant, is an 
excellent application to scrofulous or indolent tumours. The juice 
of the leaves has been applied in the same manner with equal ad- 
vantage. An ointment of the leaves with lard is good, in various 
kinds of ulcers. The roots, bruised, are sometimes applied to the 
hands and feet of the patients in ardent fevers. To make an extract, 
expose to moderate and continued heat, the juice of the berries or 
leaves, until by evaporation, it thickens to the consistence of honey. 
It may also be made from the root, which is equally efficacious. 
Boil the roots for some time, strain the decoction, and then reboil it 
to a thick consistence. Other virtues have been recently ascribed to 
this plant by respectable physicians. 

An infusion of the leaves is recommended externally as an admi- 
rable remedy for the piles. One ounce of the root steeped in a pint 



MATERIA MEDICA. 573 

of wine, and given to the quantity of two table spoonsful, is said to 
operate mildly as an emetic. — It is also said that this plant may be 
relied on as an efficacious remedy for the venereal disease, in its 
various stages, even without the aid of mercury. 

From my own experience of the virtues of poke-weed, I can re- 
commend it as a most valuable medicine in rheumatic and gouty 
affections, as also in nocturnal pains, and obstinate ulcerations in the 
venereal disease, brought on by the excessive use of mercury. The 
usual form of exhibition is the bounce, a wine glassful three times 
a-day. The bounce is prepared by filling a jug with the whole 
berries when ripe, and then pouring as much spirits to them as the 
vessel will contain. 

An ointment, prepared by simmering slowly the leaves or a hand- 
ful of the root scraped in a pint of hog's lard, with a small portion 
of bees-wax, has been used with great success in cancers, and various 
kinds of ulcers. 

POLYGONUM — An infusion of it, as a diet drink, is a powerful 
promoter of urine, and very useful in gravel complaints. 

POLYPODY, COMMON, Polypodium— Grows on old walls, 
shady places, and at the roots of trees, flowering from June to Octo- 
ber. The root has a sweetish taste, but by long boiling becomes 
bitter. An infusion of half an ounce of the fresh root in half a pint 
of boiling water, in doses of a wine glassful every hour or two, 
operates as a mild laxative. 

POMEGRANATE, Punica— Is cultivated in the southern gar- 
dens. The fruit is agreeable to the palate, and possesses the proper- 
ties of subacid fruits. — Its rind, boiled in milk, and drunk freely, or 
in powder, a tea-spoonful for a dose three times a-day, has been used 
with success, in diarrhoeas, dysenteries, and other diseases requiring 
astringent medicines. The flowers possess the virtues of the rind, 
only in a less degree. 

POPLAR TREE, OR WHITE WOOD, Liriodendrum Ttt 
lipifera — The bark of this noble tree, as well as the root, is a very 
strong bitter, and considerably aromatic. 

In intermittents, in the last stage of dysentery, and other disorders 
requiring tonic medicines, it is considered but little inferior to the 
Peruvian bark, and is generally employed in similar doses and forms. 

Professor Bigelow states that the bark is acceptable and apparently 
useful to patients who have derived occasional benefit from " Hux- 
ham's tincture," " Stoughton's elixir," and similar compositions of 
bitter and aromatic drugs. 

There is another species of poplar, the aspen tree, populus trcinula, 
the bark of which, according to Professor Barton, is also an excellent 
tonic and stomachic. 



574 MATERIA MEDICA. 

POPPY, TVTIITE, Papaver Somniferum — Grows in our gar- 
dens, and yields a juice, which, when inspissated, to a proper consis- 
tence, is called opium. 

According to the experiments of Dr. S. Ricketson, of Dutchess 
county, New York, the opium obtained from our poppies, is equal, 
if not superior to the imported. With respect to the method of 
cultivating the plant, and preserving the opium, we shall insert the 
directions given by Dr. Ricketson. 

" The poppy seeds should be planted about the middle of May, 
in rich moist ground, an inch deep, and ten or twelve inches apart, 
and kept clean. When the plants are arrived to the state of flower- 
ing, on a sun-shining day, cut off the stalks, at about an inch dis- 
tance from the flowers, and as soon as the juice appears, which it 
does at first equally well on the part of the stalks cut off with the 
flowers, as on the standing part, collect it with a small scoop, or pen- 
knife. After the juice ceases to appear on the standing stalk, it 
should be cut off about an inch lower, when it will be found to yield 
almost as freely as before, and repeated as long as any juice appears. 
The juice, when collected, should be put into an evaporating pan, 
placed in the sun's heat, and frequently stirred, till it becomes of a 
consistence to be formed into pills, or to be made into rolls for keep- 
ing and exportation. The quantity of opium that may be preserved, 
depends very much on the largeness of our plants, and the care used 
in collecting it. From one poppy plant, I have obtained seven 
grains of opium. If any would choose to have the opium freed from 
its impurities, it may be easily done, by pressing the juice, before it 
is inspissated, through a linen strainer; but if pains be taken, accord- 
ing to the foregoing directions, I believe there will be little or no 
occasion for it." 

A strong decoction of the dried heads mixed with half the quantity 
of sugar, or honey, and formed into a syrup, by simmering slowly 
by a gentle fire for an hour, is occasionally used in doses of a table- 
spoonful in coughs and breast complaints, on account of its anodyne 
effects. — Poppy heads are also used externally in fomentations and 
poultices, either alone or conjoined with the leaves of southern wood, 
camomile flowers, or other ingredients. 

POTATO, SWEET, Convolvulus Batata— From _ this root 
Bowen's patent sago is prepared, which forms a veiy nutritious jelty, 
like arrow root, and is prepared in the same manner ; to which the 
reader is referred. 

The process generally used for procuring the powder of the sweet 
potato, is to grate the clean roots, wash the mass through brass sieves 
of different sizes, and collect the flour at the bottom of the vessel 
which receives the fluid ; finally, dry it in pans either by the fire or 
in the sun. 

The vine of the sweet potato, supports the famous insect called 
the potato fly, which, from repeated experiments, is found fully equal 



MATERIA MEDICA. 575 

in all respects to the best Spanish flies. The potato flies general] v 
make their appearance about the last of July or first of August, and 
may be collected in great abundance morning and evening, by 
shaking them from the leaves in a vessel of hot water, and after- 
wards drying them in the sun. These insects will also feed upon 
the vine of the Irish potato. As they can be procured in immense 
quantities annually, with but little trouble, every family should care- 
fully collect them. 

POTATO, WILD, Convolvulus Panduratus — Grows in low 
grounds and sandy soils, near running water. — It trails along the 
ground several feet, much like a grape vine, the root very large, hard, 
and white, running very deep in the earth ; the leaves triangular, 
the flowers are whitish, with a purple tinge, and bell-shaped. It is 
called wild rhubarb, and from the article whose name it bears, is 
employed as a purgative in doses from a tea to a table-spoonful of 
the powdered root. Professor Barton says, the root in powder or 
decoction has been much recommended in Virginia, and other parts 
of the United States, in cases of gravel. The decoction is prepared 
by boiling slowly a handful of the root sliced or bruised in three 
pints of water to a quart, of which, in gravel complaints, a tea cupful 
may be taken four or five times a-day. 

PRICKLY ASH, AND PRICKLY YELLOW WOOD, Zan- 

thoxylum — Possess the same virtues. Both species are covered with 
numerous prickles, whence the name. — Both the bark and berry are 
of a hot acrid taste, and when chewed, powerfully promote spittle. 
It is used in this way to cure the toothache, as well as putting some 
within the hollow, also to cure the palsy of the tongue. 

The prickly ash has a great deal of reputation in the United States 
as a remedy in chronic rheumatism. In that disease its operation 
seems analogous to that of Mezereon and Guaiacum, which it nearly 
resembles in its sensible properties. It is not only a popular remedy 
in the country, but many physicians place great reliance on its pow- 
ers in rheumatic complaints, so that apothecaries generally give it a 
place in their shops. It is most frequently given in decoction ; an 
ounce being boiled in about a quart of water. Dr. G. Hay ward, of 
Boston, states that he took this decoction in his own case of chronic 
rheumatism, with evident relief. It was prepared as above stated, 
and about a pint taken in the course of the day, diluted with water 
sufficient to render it palatable by lessening the pungency. It was 
warm and grateful to the stomach, produced no nausea nor effect 
upon the bowels, and excited little, if any, perspiration. There is 
no medicine which I have found so effectual in relieving nocturnal 
pains, and disposing venereal ulcers to heal, as the prickly ash in the 
above form and doses. 

A tincture prepared by steeping half a pint of (he berries, or a 
handful of the bark, in a bottle of spirits, is much esteemed as a re- 



576 



MATERIA MEDICA. 



medy in doses of a wine-glassful, in flatulent colics. It is sometimes 
employed in this form, in cold phlegmatic habits, afflicted with the 
rheumatism. 

PRICKLY PEAR — Grows on sandy lands and rocky places. A 
large handful of the pear cut in slices, boiled in a quart of milk, and 
taken in doses of a gill every morning, is reputed to be of great ben- 
efit in scurvy, dropsy, cancers, and cutaneous eruptions; and that the 
inner soft mucilage of the pear, while green, on a rag, to ulcers, 
morning and night, is very efficacious. It is also said that a fresh 
piece of the inner side of the pear, applied twice a-day to corns, af- 
ter soaking the feet in warm water, and paring off the horny part, 
will, in a few days, perform a cure. 

PRIDE OF INDIA, OR CHINA, Melia Azedarach— Is now 
completely naturalized to the southern states. The public walk and 
streets of Savannah and Augusta, are ornamented by rows of this 
tree, a mile long, which furnish a most delighful shade against the 
scorching sun, and add not less to the healthiness than to the beauty 
of these cities. Independently of its luxuriant verdure, and cooling 
shade, it is highly valuable for its medicinal properties, being now 
ascertained to be one of the best vermifuges in nature. 

Many physicians in the southern states have witnessed its re- 
markable effects in destroying and dislodging worms. It has been 
even found a remedy against the tape- worm. 

I have not myself made use of this medicine, possibly because of 
the deleterious effects of the berries on some pigs and a parrot. 

In the fall of the year 1795, at a country seat which I then owned, 
in Lancaster county, Virginia, a sow with eight or ten pigs came into 
the yard where I had several trees of the Pride of China, and ob- 
serving the pigs to eat with avidity of the berries, which were drop- 
ped on the ground, I had many of them thrown from the tree, and 
in a few hours all the pigs were seized with the common symptoms 
of inebriation, and died. The sow did not appear to be the least 
affected, although she also ate of them. The death of the pigs 
would not have operated so strongly on my mind had it not been for 
a parrot, which not long after fell a victim to these berries. This 
enchanting bird, which spoke many words as plainly as a human 
person, and w T hich for several years had been a pet in the family of 
Dr. Andrew Robertson, the father of Mrs. E #### , had not long ar- 
rived at its new home, before it was tempted to eat of the fruit of 
this tree. A gentleman who was not apprized of the deleterious 
properties of this berry, presented the much admired Poll with one 
of them, which she soon ate, and relished it so well, as loudly to call 
out, "give me some more! give me some more !" After consum- 
ing several, she, in a short time, fell into a state of stupefaction, fol- 
lowed by a violent purging, which soon terminated her existence. 

The common modes of using this medicine, are the infusion or tea, 



MATERIA MEDIC A. 577 

and saturated decoction. Of the former, a handful of the bark to a 
quart of boiling water, is given in doses of a small tea-cupful morn- 
ing and night. The decoction is made by boiling a large handful 
of the fresh bark of the root in three pints of water, to a quart, which 
is given to children in doses from a half to a whole wine-glassful. 
Dr. Kollock, of Savannah, observes, when exhibited in the latter 
form, every three hours, until it operates, he has found it beneficial 
as a febrifuge in those affections usually denominated worm fevers, 
but where no worms are voided. The pulp which invests the stone 
of the fruit, pounded with tallow, has been successfully employed in 
cases of scald head. Would not an ointment prepared by slowly 
simmering the root in hog's lard, be found also an excellent applica- 
tion to that loathsome disease; also the tetter worms and ulcers? 

PUCCOON. See Blood Root. 

QUEEN OF THE MEADOWS— Grows in hedges, and on 
the sides of meadows, about four feet high ; the stalk reddish, leaves 
long, spear-shaped, and opposite each other, flowers purple. 

A large handful of the roots boiled in three pints of water to a 
quart, and given in doses of a tea cupful every two hours, is said to 
be an excellent remedy in suppression of urine, and for carrying off 
the water in dropsy. 

QUINCE TREE, Pyrus Cydonia — The liquor expressed from 
the ripe quince, also the syrup, has frequently been given with great 
success in nausea, vomiting, and fluxes. 

The juice of the quince with sugar, a gallon of one to two pounds 
of the other is said to make a most delightful wine. The ripe fruit, 
sliced and steeped in French brandy or spirits, with a little sugar, or 
equal parts of the juice and spirits sweetened, forms an admirable 
cordial and stomachic. The quince makes also a nice preserve, and 
the seeds a fine mucilage, which, with sugar and nutmeg, is an ex- 
cellent drink in dysentery. 

RADISH, Raphanus — Is esteemed as an antiscorbutic, particu- 
larly if eaten with the skin. When old, or after having been kept 
some time, they ought to be avoided, especially by persons of weak 
stomachs, as apt to create indigestion and colic, and to render the 
breath disagreeable. 

RASPBERRY, Idaus — Like the rest of the rich subacid fruit. 
when ripe, are wholesome and nourishing. Raspberries, as well as 
strawberries, held in the mouth, will dissolve tartarous concretions 
formed on the teeth. 

RATTLE, OR SENECA SNAKE ROOT, Polygok* Senega 

— Grows nearly a foot high, the leaves pointed, and somewhat oval: 
73 



578 MATERIA MEDIC A. 

the stalks upright and branched, the flowers white, the root variously 
bent and jointed, whence it is supposed to resemble the tail of the 
animal whose name it bears. 

The first reputation of the Seneca root was one which it divides 
with a multitude of other plants, that of curing the bite of the rattle 
snake. A reward was given by the legislature of Pennsylvania, to 
Dr. Tenant, for the promulgation of this supposed property. When, 
however, we consider the number of cases of recovery from the bite 
of this serpent, under every variety of treatment, we cannot avoid 
the conclusion, that these injuries are not necessarily dangerous, and 
that spontaneous recoveries are, perhaps, as frequent as those which 
are promoted by medicine. 

In violent colds, croup, pleurisy, acute rheumatism, and all in- 
flammatory complaints, I can recommend it as an admirable medi- 
cine to promote perspiration. The best form of using it is in decoc- 
tion, a handful to a quart of boiling water, a wine glassful to adults, 
every two or three hours, increasing or lessening the quantity to avoid 
vomiting and purging. 

Professor Chapman recommends it very highly in obstructions of 
the menses ; four ounces of the decoction to be taken in the course 
of the day, increasing the quantity when the menstrual effort is ex- 
pected, as far as the stomach will allow. If this excite nausea, aro- 
matics are to be added, as cinnamon, calamus and angelica. 

Dr. Archer, of Harford county, Maryland, was among the first 
who noticed the efficacy of this medicine in cases of croup or hives. 

He directs a tea-spoonful of the strong decoction to be given to a 
child every hour or half hour, as the urgency of the symptoms may 
demand, and, during the intervals, a few drops occasionally, until it 
acts as an emetic or cathartic ; then repeated in small quantities, to 
keep up a constant stimulus in the mouth and throat. Patients who 
use this medicine, should not be permitted to drink any thing what- 
ever for some time after each dose. He employed it in the form of 
a powder in doses of four or five grains, mixed with a little water. 

Professor Barton, with his usual candour and liberality, observes, 
" I am persuaded that the Seneca is a very important medicine in 
the treatment of this common, and too frequently unmanageable dis- 
ease; and praise is, in my opinion, due to Dr. Archer for his impor- 
tant discovery, for such I cannot but deem it. That the Seneca is 
a specific or certain remedy for the cure of croup, I do not believe ; 
but from my own experience I am led to repose more confidence in 
the use of this medicine than in any other. I have made use of a 
very strong decoction of the root. I have always given it in large 
quantities. It appears to be chiefly beneficial when it occasions an 
expectoration of mucus, and when it proves emetic. It is also very 
useful by virtue of its purgative quality. But I have known it oc- 
casion very plentiful stools, without benefiting the patient. Indeed, 
m the exhibition of Seneca, I would rather wish to guard against 
large purgings. I have sometimes treated my patients almost entirely 



MATERIA MEDIC A. 0/\J 

with Seneca. Even in such cases I have perceived most un equi- 
vocal good effects from it : but, have more generally given along 
with the Seneca, calomel, and sometimes calomel combined with 
ipecacuanha. I have not omitted the employment of the lancet, 
though this in many cases of croup is not absolutely necessary, and 
the use of blisters or sinapisms applied near the seat of the disease. 
I am happy to close this short notice by observing, that several re- 
spectable physicians in Philadelphia inform me that they have used 
the Seneca with much advantage in the disease in question. 

In various forms of dropsy, the Seneca root has been resorted to 
with advantage, and has received the commendations of Percival, 
Millman, and some others. Its cathartic and diuretic effects are 
very considerable, when persevered in, in large quantities; and have, 
in many instances, effected the dissipation of dropsical swellings. 
In the prevailing epidemic I have found a decoction of this vegeta- 
ble, taken freely at the commencement of the disease, a medicine of 
great utility. 

RATTLESNAKE YIOLET. See Violet. 

RED CEDAR, Juniperus Virginiana — Is found from Lake 
Ghamplain to the Cape of Florida. The leaves have a strong disa- 
greeable taste, with some pungency and bitterness. Its most fre- 
quent use is in the composition of the cerate employed for keeping 
up the irritation and discharge of blisters. This preparation is the 
same with the Savin cerate, used in Europe, the leaves of the red 
cedar being substituted for the Savin. When properly prepared by 
boiling the fresh leaves for a short time in about twice their weight 
of lard, with the addition of a little wax, a cerate is formed, of pecu- 
liar efficacy as a perpetual epispastic. When applied as a dressing 
to a newly vesicated surface, and afterwards repeated twice a-day, it 
rarely fails to keep up the discharge for an indefinite length of time. 
Under its operation, the discharge usually changes from a serous to 
a puriform appearance, and concretes upon the surface ; so that it re- 
quires to be removed from time to time, to admit the full action of 
the cerate. 

Internally, the leaves have been found to exert effects very similar 
to those of the Savin. They have proved useful as an emenagogue, 
and as a general stimulant and diaphoretic in rheumatism. They 
have also had some reputation as a diuretic in dropsy. 

RHUBARB, WILD. See Potato, Wild. 

ROSE, Rosa. — The hundred-leafed, or damask rose, is justly 
termed the queen of flowers. Otto, or essence of roses, is obtained 
from these by distillation, and is doubtless the most elagant perfume 
in vegetable nature. Independently of their use in this manner, a 
decoction of its leaves will be found a mild laxative, and, when 



580 MATERIA MEDICA. 

formed into a syrup, may be given with advantage to children. 
The conserve of roses is also prepared from them for medicinal 
purposes. 

ROSE WILLOW, Salix — Grows near brooks, along the banks 
of rivers, and on the borders of meadows. It is about the size of an 
apple tree, and covered with a grayish -coloured bark, and very red 
within, with a bunch in the top resembling a bunch of roses. 

Four ounces, or a large handful of the bark, boiled in three pints 
of water to a quart, and taken in doses of a tea-cupful three or four 
times a-day, is said to be an excellent remedy in cases of gleet, 
the whites, immoderate flowing of the menses, and in cutaneous 
eruptions. 

RUE, Ruta — Has an ungrateful smell, and a pungent bitter taste. 
The leaves are acrid, and when applied to the skin are apt to 
produce blisters. Employed in the form of tea, they are reputed to 
be of great service to persons of cold phlegmatic habits. According 
to Boerhaave, an infusion of the leaves powerfully promotes perspi- 
ration, quickens the circulation, removes obstructions, and is particu- 
larly adapted to weak and hysterical constitutions, suffering from re- 
tarded, or obstructed secretions. 

SAGE, Salvia — An infusion of the leaves or tea, is considered 
serviceable to persons of cold phlegmatic habits, labouring under 
nervous debility. Sweetened with the addition of a little lemon 
juice, it forms an exceedingly grateful and useful drink, in febrile 
disorders. 

Sage was supposed by the ancients to possess the virtue of pro- 
longing human life; hence the following verse : "Cur moriatur 
homo, cui salvia crescit in horto?" How can a man die, in whose 
garden there grows sage? in allusion to its many virtues. What a 
shameful abuse of this pretended property was made by the late Sir 
John Hill, in his patent tincture of sage, for the prolonging of human 
life, and warding off old age, is known to every one. This conduct 
could not fail to draw upon him the pen of the wits of the age; 
and Garrick, with Thomson, conjointly, published the following 
epigram : — 

"Thou essence of dock, valerian, and sage,, 
At once the disgrace and pest of the age, 
The worst that we wish thee, for all thy bad crimes, 
Is to take thy own physic, and read thy own rhymes." 

Dr. Hill made the following reply : — 

"Ye desperate junto, ye great or ye small, 
Who combat dukes, doctors, the deuce, and them all, 
Whether gentlemen, scribblers, or poets in jail, 
Your impertinent curses shall never prevail : 
I'll take neither sage, dock, nor balsam of honey ; 
Do you take the physic, and I'll take the money." 



MATERIA MEDICA. 581 

Such shameless imposition on common sense, deserves something 
worse than ridicule ; for deceiving the sick and helpless, they merit 
the execrations of every man who has one spark of humanity. 

SAMSON SNAKE ROOT— Grows from six to twelve inches 
on diy land, and bears on the top two or three pale blue flowers ; 
leaves opposite, sword-shaped; the root matted, variously bent, and 
has an agreeable bitter taste 

Upon the respectable authority of the honourable William May- 
rant, of South Carolina, the root of this plant possesses in a very 
great degree tonic powers. He stated to me, that being himself re- 
duced to a mere skeleton by dyspepsia, or indigestion, and having 
tried the usual remedies employed in such cases, without receiving 
any benefit, he was at length induced, as his last hope, to try the 
virtue of this plant, which had been recommended to him by a negro 
man. He was directed to steep a handful of the root in a bottle of 
spirits, of which he was to take half a wine glassful diluted with wa- 
ter three times a-day ; and such was the astonishing effect wrought 
by this medicine, that in a few weeks his health was perfectly rein- 
stated. He discovered the plant to grow near Fredericksburg, Vir- 
ginia, and collected some of it to exhibit in Washington. Several 
persons in delicate health, and troubled with dyspepsia, were readily 
persuaded, from the recommendations of Col. Mayrant, to make 
use of his favourite remedy, and not without receiving considerable 
benefit It may be taken in the form of powder, tincture, or de- 
coction. 

SANICLE, AMERICAN. See Alum Root. 

SARSAPARILLA, Smilax Sarsaparilla — Grows in several parts 
of the United States. It is a small vine resembling a bramble. 

A decoction of sarsaparilla, prepared by boiling a large handful 
of the root in a quart of w T ater, till the third part be evaporated, has 
long been employed as an auxiliary to mercury, in the treatment of 
venereal complaints. It promotes perspiration, attenuates viscid 
humours, relieves venereal headache, nocturnal pains, and disposes 
venereal ulcers to heal. In rheumatic affections, cutaneous disor- 
ders, and scrofula, it is a very useful medicine. It may also be ex- 
hibited in the form of powder in doses of two drachms, or extract in 
doses of one drachm, three or four times a-day. 

SASSAFRAS, Laurus Sassafras. — An infusion or tea of the 
flowers, or bark of the root, has often been successfully given as a 
sweetener or purifier of the blood, in scorbutic, venereal, and cuta- 
neous disorders, or where an acrimony of the fluids prevails. Con- 
joined with bark of dogwood, cherry tree or oak, it is very useful in 
obstinate intermittents. The oil, externally applied, in die chronic 
rheumatism, and also in wens, has oftentimes proved salutary. The 



582 MATERIA MEDIC A. 

pith of the small twigs, in water, forms a mucilage of excellent use 
for sore eyes, and as an injection in the incipient stage of gonorrhoea. 
It also affords, when sweetened, with the addition of nutmeg, a 
palatable jelly, useful in dysentery and febrile diseases. 

SCULL CAP, BLUE. See Hooded Widow Herb. 

SCURVY GRASS, Cochleara Officinalis — Is a pungent stimu- 
lating plant, and in the simple state of a salad, or, in the form of ex- 
pressed juice, a wine-glassful three times a-day, has long been es- 
teemed one of the best of all the antiscorbutic plants. 

SENNA, AMERICAN, Cassia Marilandica— Is easily cultiva- 
ted from the seeds, and ought to be more generally introduced in 
our gardens. 

It has long been employed as a purgative. To increase its effects 
on the bowels, manna, salts, or tamarinds, are generally added. To 
correct its ill flavour, and prevent griping, it should be joined with 
some aromatics, as coriander or fennel seed, ginger, &c. In the 
form of decoction, a handful to a pint of boiling water, the dose is a 
tea-cupful every hour or two until it operates. It may also be ex- 
hibited in the form of tincture, to relieve flatulent colics, four ounces 
of senna to a quart of spirits, with an ounce of coriander seed, or 
ginger, and a wine-glassful the dose. 

SKOKE. See Thorn Apple. 

SKUNK CABBAGE, DraconituF&tidum — Abounds in swamps 
and meadows, and emits a disagreeable smell, nearly resembling that 
of a skunk or polecat, and from this, and its leaves resembling those 
of a cabbage, it has acquired its name. 

The roots dried and powdered, have proved of excellent use in 
asthmatic cases, and often afforded relief in this distressing disease, 
when other means were ineffectual. It should be exhibited during 
the paroxysm, and repeated as circumstances may require, in doses 
of thirty or forty grains. It will be proper to persevere in the use of 
it for some time after the paroxysm has gone off, until the patient 
has perfectly recovered. 

Dr. Cutler has celebrated its efficacy in his own case of asthma, 
after other medicines had failed. In one of the most violent asth- 
matic cases, two tea-spoonsful of the powdered root, in spirits, pro- 
cured immediate relief; and, on repeating the trials with the same 
patient, it afforded more lasting benefit than any other medicine. In 
childbed it produces the desired effect, in doses of a tea-spoonful re- 
peated occasionally. In numerous other instances of spasm, and also 
in chronic and acute rheumatism and dropsy, in powder or decoc- 
tion, it has performed important cures. The seeds possess the same 
virtues as the root. 



MATERIA MEDICA. 583 

Dr. Cutler vehemently cautions, that, in collecting the roots, the 
white hellebore, or poke root, which some people call skunk weed, 
be not mistaken for this plant, as the consequence might be fatal. 
There is an obvious difference ; the hellebore has a stalk, but the 
skunk cabbage has none ; and the roots of the latter are much larger 
than those of the former. 

SNAKE ROOT. See Virginia Snake Root. 

SOAPWORT, Saponaria Officinalis — Grows in moist swamps 
and meadows, particularly on the Ohio river, where it is used as a 
substitute for soap. It rises about a foot high, the leaves are pointed, 
and furnished with three ribs, the flowers numerous, large, and of a 
pale pink colour. 

A handful of this plant boiled in three pints of water to a quart, 
in doses of half a pint, three or four times a-day, has been found 
useful in the jaundice, obstructions of the liver, and the venereal 
disease. 

SORREL, Oralis Acetosella — Called also sour trefoil, or cuckow 
bread, yields, on expression, a grateful acid juice, which has been 
beneficially used in the scurvy and scorbutic eruptions. An infusion 
of the leaves makes a palatable diet drink in fevers, and on being 
boiled in milk, forms an agreeable whey. A conserve made of the 
leaves, with double their weight of loaf sugar, forms an excellent 
substitute for lemons, and may be given with advantage, in all pu- 
trid and other fevers, where antiseptics are indicated. The leaves 
bruised, and externally applied to scrofulous ulcers, have produced 
excellent effects, by promoting suppuration and granulation. 

SOUTHERN WOOD. See Mugwort. 

SOUTH-TEA, OR YAUPON, Alex Vomotoria— Grows abun- 
dantly in the southern states. It rises about twelve feet high, shoot- 
ing into many upright, slender, stiff branches, covered with whitish 
smooth bark; the leaves small, evergreen, and saw-edged; the flow- 
ers small and white, and grow promiscuously among the leaves, 
succeeded by small berries, which become red in October, and re- 
main so all the winter. 

It is held in great esteem among the southern Indians. They 
toast the leaves, and make a decoction of them, which is called black 
drink. 

An infusion, or tea of the leaves, is considered as palatable as Bo- 
hea tea, and when used freely, is a powerful diuretic, and hence of 
service in the cure of dropsy and suppression of urine. 

SPIKENARD, Aralia Racemosa — Grows in low rich grounds 
and among rocks, to the height of three or four feet; the leaves are 



584 MATERIA MEDICA. 

many, on long branches, from a thick purplish stalk, flowers very 
small, of a bluish colour, producing berries much resembling those 
of the elder, of a sweetish pleasant aromatic taste. The roots are 
very long, and about the thickness of a linger. 

A pint, of berries steeped in a quart of spirits, in doses of a wine- 
glassful, is said to be a speedy cure for the gout in the stomach. 
The roots in the form of infusion, a handful to a quart of water, and 
given in doses of a tea cupful three or four times a-day, have been 
found efficacious in gouty complaints. The fresh root applied in 
the form of poultice, is said to be excellent for wounds and ulcers. 

SPLEENWORT. See Maiden Hair. 

SPRUCE LAUREL. See Mezereon. 

SQUIRREL EAR, OR EDGE LEAF— According to the late 
Paul Hamilton, Esq., is produced on barren pine land, in Carolina 
and Georgia. It is a species of sage, and very efficacious as an anti- 
dote to the poison of the snake bite. It is known by the remarkable 
characteristic which forms its name; the leaf, instead of the surface, 
presents its edge to the sun, and is in colour and shape, very much 
like the ear of the squirrel, although larger. The stalk never rises 
beyond three feet, and its leaves are alternate and transverse. 

A wine-glassful of the juice of this plant has been known to rescue 
from death persons bitten by the rattlesnake, who were so far gone, 
as to be incapable of speaking. The flower of this plant is white 
and fuzzy, and appears in every warm month in the year; the smell 
that of mellilot, with a slight tincture of the aromatic. 

STAR GRASS, Aletris Farinosa — Grows in fields and about the 
edges of woods, and flowers in June and July. The leaves are 
grass-like, but smooth and stiff, of a willow-green colour, and spread 
like a star upon the ground. " No plant," says Dr. Bigelow, ''sur- 
passes this in genuine, intense, and permanent bitterness." Hitherto, 
it has been chiefly used as a tonic, exhibited in small doses. 

STINK WEED. See Thorn Apple. 

STRAWBERRY, Fragaria— The fruit of this plant is delicious, 
and being of a cooling and laxative nature, may be considered as 
medicinal. If freely eaten, they impart their peculiar fragrance to 
the urine, and when retained in the mouth for some time, dissolve 
tartareous concretions on teeth. They are of great service in cases 
of scurvy, and, according to Linnseus, a copious use of them has 
proved a certain preventive of the stone in the kidneys. An infusion 
of strawberry leaves, while young and tender, makes excellent tea ; 
but for such purpose they ought to be dried in the shade, being 
slightly bitter and styptic. They have been used with advantage m 



MATERIA MEDICA. 585 

laxity and debility of the intestines, as likewise in hemorrhages and 
other fluxes. Lastly, they are of considerable service as aperients in 
suppression of urine, visceral obstructions, and jaundice. 

SUMACH, COMMON, Rhus Copallinum.— The berries or seeds, 
when ripe, are red and very acid. An infusion of them, sweetened 
with honey, is a good gargle for the sore throat, and for cleansing 
the mouth in putrid fevers. 

Mr. Jesse Torrey considers the bark of the root of sumach to be 
one of the best antiseptics produced by vegetation. Corroding ul- 
cers, defying every common application, immediately began to heal 
by washing them with a strong decoction, and applying the boiled 
bark as a poultice. He says it is a very important material in decoc- 
tions for hectic and scrofulous diseases. Sumach constitutes one of 
the ingredients of the following recipe, which was handed to me by 
a gentleman of the first respectability and veracity, as a remedy for 
the venereal disease. 

Of the inner bark of pine and swamp elm, and the bark of the 
root of sumach, take each one pound ; boil them in a gallon of water 
to three quarts, drink half a pint three times a-day: if costiveness 
be produced, a dose of salts may be used. If there be ulcers, they 
are to be washed with a decoction made warm. The detergent 
effects will appear in a very short time. Abstinence from too much 
stimulants will accelerate the cure. This remedy is one of Heaven's 
best mercies to offending man ; and instances can be produced of 
the effects of it, which would stagger credulity. Mercury, and 
nitric acid have failed, but this has never been known to fail when 
properly applied. It is, moreover, a fine application in dysenteric 
affections. 

SUNDEW, Ros Solis— Called also red root, or youthwort. 
Grows in mossy bogs, flowering in July and August. 

The whole of this singular plant is acrid, and its juice sufficiently 
caustic to corrode corns and warts. It is said, the juice, properly 
mixed with milk, and applied to the skin, will remove freckles and 
sun-burns 

SWALLO WWORT. See Pleurisy Root. 

TANSY, Tanacetum Vulgare. — This -plant possesses a warm 
taste, and may be used as a substitute for hops. An infusion of the 
leaves is recommended for a weak stomach, hysteric complaints, and 
obstructed menses. 

According to Dr. Withering, its seeds are an excellent vermifuge, 
in doses from a scruple to a drachm, and that if animal substance be 
rubbed with the herb, it will be effectually preserved from the attack 
of the flesh fly. 
74 



586 



MATERIA MEDICA. 



THORN APPLE, Datura Stramonium — Has a variety of 
names, as James-town, or jimson weed, French apple, stink w r eed, 
&c. Its common name, James-town weed, is said to have arisen 
from the circumstance of a number of sailors being violently diseased 
by ignorantly eating the boiled plant at Jamestown, in Virginia, at 
its first settlement. It grows among rubbish, and on dunghills, to 
the height of two or three feet, flowers in July and August. The 
corolla is funnel-shaped and plated white with a tinge of purple. 
The capsule is large, egg-shaped, and covered with thorns, which 
have four divisions, and contain numerous kidney-shaped seeds. 
The leaves are large, egg-shaped, and deeply indented, of a disa- 
greeable smell, and nauseous taste. 

Every part of this plant is a strong narcotic poison ; nevertheless, 
when judiciously administered, it is unquestionably one of the most 
valuable medicines in our possession. Professor Barton considers it 
a medicine of great and invaluable powers, especially in cases of 
mania, attended with little or no fever, or with a cold skin and lan- 
guid circulation. The form in which he exhibited it, w T as that of 
an extract prepared from the fresh leaves, beginning with a few 
grains, and gradually increasing the dose to fifteen or twenty grains. 
In one case of mania, in a woman, he increased it to sixty grains. 
In a few weeks it brought on an eruption in various parts of the 
body, " and she was dismissed," he observes, " from the hospital, per- 
fectly cured." Dr. Fisher recommends it highly in those cases of 
mania in young persons, where fits occur daily, or monthly, at regu- 
lar periods, especially if assisted by chalybeates, or such other medi- 
cines as particular symptoms require ; but advises the free and regu- 
lar use of it, one or two doses every day. The most convenient 
form, especially for children, he thinks, is the saturated tincture: the 
requisite dose may be known by the dilatation of the pupils. 

Dr. Alexander King, of Connecticut, has employed this medicine, 
in the form of decoction, one drachm of the seed bruised, boiled in 
half a pint of water to a gill, in several cases of inflammation of the 
brain, attended with delirium. The following is one of the cases re- 
cited by the doctor. 

A man of robust constitution, and sanguine habit, about twenty- 
six years of age, after drinking pretty freely, w T as seized with a slight 
paroxysm of the apoplexy, which was followed by a cold fit of fever, 
attended w T ith a violent pain of the head, and delirium. On the 
second day, I found him delirious, with an inflammation of the 
brain, or rather the meninges. I bled him largely, so that he even 
fainted in a recumbent posture, which was succeeded by another 
partial paroxysm, similar to the first. I put him on a course of 
medicine, nearly the same as prescribed in a former case. The next 
day I found no abatement of the symptoms ; he had slept none for 
two nights past, and was quite outrageous. I then prescribed for 
him a decoction of the seeds of the datura stramonium, and directed 
the nurse to give him a tea-spoonful every quarter of an hour. I 



MATERIA MEDICA. 587 

found, on visiting him the next morning, that soon after taking the 
decoction, he became calm and composed, and went to sleep. I 
continued the same medicine through the course of the fever, which 
lasted about seven days, except one day in which I purposely omit- 
ted the use of it, in order fully to satisfy myself as to the operation 
of the medicine. On that day the delirium returned, and he slept 
none the night following. The next morning I had recourse to the 
decoction as usual, and it produced the same salutary effects as 
before. 

In this case, I had a fair opportunity to observe the action of the 
medicine, in an early stage of the disease, which was cooling, ano- 
dyne, and sedative. 

As a remedy in epilepsy, Professor Barton thinks it may be relied 
on even in the most deplorable cases. A lady, aged fifty-five, having 
for some months been afflicted with alarming attacks of epilepsy, by 
which her powers of intellect and of articulation were impaired, hap- 
pily experienced a restoration, by taking one grain of the extract 
once in twenty-four hours. Although she did not suffer another at- 
tack, after commencing the course, she found it necessary to continue 
it for several months, to remove all apprehensions of a recurrence. 
A single grain seldom failed to excite unpleasant vertiginous sensa- 
tions, accompanied with efflorescence of her face, and some degree 
of sleepiness. In asthma and spasmodic cough, stramonium is said 
to have proved essentially beneficial. It is also said to have pro- 
duced salutary effects in cases of chronic rheumatism, and difficult 
menstruation. 

As this medicine is indued with most active powers, it ought to be 
administered in very small doses at first, and the quantity gradually 
increased daily, until it produce, in a slight degree, vertigo or dilata- 
tion of the pupil. 

In the course of my practice, I witnessed the deleterious effects of 
this plant in a child, who was attacked with convulsions similar to 
those which attend persons afflicted with the disease termed St. Vi- 
tus's dance, accompanied with delirium, tremour, thirst, glaring 
eyes, dilated pupil, and considerable efflorescence of the skin. The 
parents were perfectly ignorant of the cause of the child's sudden 
indisposition; but from the symptoms, I was convinced it had taken 
some of the stramonium, and on making the necessary inquiries, 
learned that it had been playing with some of the seeds a few hours 
before. Immediately on visiting the child, I directed the warm 
bath, and gave it six or eight grains of blue vitriol, which was re- 
peated at the interval of fifteen minutes, before it excited vomiting-. 
when some of the seeds were thrown up. After the operation of the 
emetic, I administered a large dose of castor oil, which, assisted by 
stimulating injections, produced in a few hours some evacuations, 
and the child was entirely relieved from all those distressing- symp- 
toms. Domestic practitioners will recollect, that two or three grains 
of blue vitriol is a full dose for adults; and the large dose given in 



58S MATERIA MEDICA. 

this case, was from persuasion that the child's stomach had been de- 
prived of its sensibility, through the narcotic effects of the poisonous 
seeds. 

The extract may be made by exposing the juice of the plant to 
the heat of the sun, or by boiling the bruised seed or leaves in water 
for the space of four hours; then strain off the liquor, evaporate over 
a gentle fire, without taking off the scum, until it has acquired the 
thickness of syrup : then place it in a warm oven, in an earthen ves- 
sel, until it becomes of a proper consistence for use. The dose is 
from one to two grains, or more, for an adult. The saturated tinc- 
ture is prepared by steeping one or two hands full of the leaves in 
a half pint of spirits for a few days. 

The stramonium has also been employed externally with the most 
happy effects. In recent wounds, inflammations, or bruises, the 
leaves, either alone, or united with bread and milk poultice, have 
been applied to the part with manifest advantage. In the form of 
ointment, which is prepared by simmering slowly the fresh leaves 
bruised in hog's lard, with about one-eighth part of bees-wax, for an 
hour, and then strained through a coarse cloth, it will be found ex- 
cellent for the piles, scalds, and burns. From my own observation 
it far excels all other applications I have made to obstinate cutaneous 
sores, ill-conditioned ulcers, and painful cancerous affections. 

THOROUGHWORT, Eupatorium Porfoliatum—ls known 
also by the following names : thoroughstem, crosswort, boneset, and 
Indian sage. The first of these names, thoroughstem, has been im- 
posed upon it from the peculiar structure of the leaves, which are 
opposite, and appear as though the stem were thrust through them. 
It has received the second name, of crosswort, by which it is known 
in many parts of Virginia, from the position of the leaves, each pair 
of which take their origin from opposite sides of the stem, so that 
they cross each other nearly at right angles. I am at a loss, says 
Professor Barton, to refer the word boneset to its real origin ; but I 
presume the plant received this name from the great relief which on 
many occasions, it has been found to afford to persons labouring 
under violent remitting and other fevers, in which the bones are 
greatly pained. The resemblance of the leaves of this plant to 
those of the common sage, was long ago remarked by the botanists. 
Hence the name Indian sage, by which the eupatorium is known in 
some parts of Pennsylvania. 

This plant flourishes in wet meadows, and other moist places. 
The stalk is hairy, and rises from two to four feet. The flowers are 
white, and appear in July and August. The leaves at each joint 
are horizontal, saw-edged, and rough, from three to four inches long, 
and about one inch broad at the base, gradually lessening to a very 
acute point, of a dark green, and covered with short hairs. 

This plant possesses very active powers, and has been exhibited 
with uncommon advantage in intermittents, remittents, and other 



MATERIA MEDICA. 589 

diseases of debility. When exhibited m the form of a warm decoc- 
tion, a handful of the herb boiled in a quart of water, a wine-glassful 
every two hours, has proved peculiarly beneficial, says Professor 
Barton, in fevers, by exciting a copious perspiration. In larger doses 
it proves emetic ; with which view it is used in some parts of the 
United States, as an excellent remedy in intermittents. The dried 
leaves in powder, in doses of twelve or fifteen grains, are said to 
operate gently on the bowels. Every part of this plant may be ad- 
vantageously employed in practice. The flowers, as a tonic bitter, 
are deemed equal to the flowers of camomile, for which they might 
be substituted on many occasions. 

This medicine has also been found very efficacious in cutaneous 
diseases. In a peculiar and distressing affection of the herpetic 
kind, which was formerly very common in Virginia, and there 
known by the name of James River ring worm* Professor Barton 
states, from the respectable authority of Dr. Thomas Knox, of Cul- 
pepper county, Va., that a decoction of this plant drunk daily, for a 
considerable time, made a perfect cure. A wine-glassful of the ex- 
pressed juice of the green herb drunk every hour, is celebrated as a 
certain cure for the bite of a rattlesnake. The bruised leaves should 
be applied to the part. 

THROAT ROOT. See Avens. 

THYME, GARDEN, Thymus Vulgaris— Is one of the most 
powerful aromatic plants, and, as such, is frequently employed in 
the form of tea, in those complaints where medicines of this class 
are indicated. 

TOBACCO, Nicotiana Tabacum — This " obnoxious luxury," 
is a medicine of the most uncommon powers; being emetic, cathartic, 
sudorific, diuretic, expectorant, narcotic, and anti-spasmodic ; hence 
its utility in a variety of diseases. 

A table spoonful of an infusion, one ounce in a pint of boiling 
water, will excite vomiting ; however, as it has no peculiar property 
as an emetic, and its operation is attended with severe sickness, it is 
not often employed with this view. As a purgative, it is employed 
in the form of clysters, in all cases of obstinate costiveness. Ex- 
hibited in this form, in the quantity of two or three table-spoonsful 
of the infusion, mixed to half a pint of milk or thin gruel, it has fre- 
quently afforded almost instantaneous relief in violent, colics, after 
other medicines had proved ineffectual. If this quantity produce no 
relief, nor excite giddiness nor nausea, the injection may be repeated 
every half hour, with the gradual increase of the infusion, till one 

* This disgusting disease prevailed mostly among the inhabitants on James 
River. It attacked the thighs, the scrotum, and especially the parts immedi- 
ately adjacent to the arms. It extended its ravages into the rectum and per 
haps much farther. 



590 MATERIA MEDICA. 

or other of the effects take place. By this mode of proceeding, the 
violent effects of tobacco may always be avoided. As a diuretic, it 
has on many occasions proved an invaluable remedy, as in ascites 
and other dropsical affections, also in gravel, or difficulty of making 
water. In those cases, according to Dr. Fowler, the dose for adults 
should be from sixty to one hundred drops of the infusion in a tea- 
cupful of water twice a-day, about two hours before dinner, and at 
bed- time ; it being observed to disagree most with the stomach in the 
morning fasting. And, such is the difference between the morning 
and night, that almost every patient will require to take one-fourth, 
and some one-third more in the forenoon than in the evening, in 
order to enable them to bear the dose with equal convenience. The 
common dose just mentioned, relates only to adults of an ordinary 
constitution ; for it deserves particular notice, that between constitu- 
tions which are nervous and irritable, and those which are very ro- 
bust or toipid, or long accustomed to the use of tobacco, the dose 
will admit of very great and surprising alterations. 

As an expectorant, in asthmatic cases, unattended with inflamma- 
tory symptoms, this medicine has frequently afforded relief. In cases 
of tetanus, or lock-jaw, injections of tobacco infusion, says Dr. Mease, 
have been used with success. They not only produce evacuations 
from the bowels, which are generally obstinately constipated, but 
tend to a relaxation of the violent spasms so peculiar to this disease. 
On this account he suggests the propriety of giving it in the dreadful 
disease produced by the bite of a mad dog. 

Besides the internal use of tobacco in the above diseases, it is like- 
wise commended for its virtues externally employed. In the tooth- 
ache, a piece of lint moistened with the expressed juice of tobacco, 
has often acted as a charm in mitigating the pain. In obstinate 
ulcers, an ointment, or the dried leaves of tobacco, steeped in 
water, and applied to the part affected, have been attended with 
beneficial effects, after the usual remedies had failed. In the itch, 
and obstinate cases of cutaneous eruptions, the tobacco infusion, as 
a wash, applied two or three times a-day, seldom fails of effecting a 
radical cure. In that detestable distemper, called lousy evil, to 
which many children are subject, though, from neglect of cleanli- 
ness, adults are sometimes afflicted with it, the infusion has effected 
a radical cure, in several instances, after preparations of mercury, 
and other applications, had failed. It will be found equally destruc- 
tive to crab-lice, if applied two or three times a-day to the parts 
which they infest. 

In cases of worms, tobacco, externally applied, is deserving the 
highest estimation. Professor Barton states, that the leaves pounded 
with vinegar, and applied in the shape of poultice to the region of 
the stomach and abdomen, have often discharged worms, after 
powerful anthelmintics had been exhibited internally in vain. " We 
ought not to be surprised," says he, " at this effect of the tobacco, 
since we know that the same vegetable, applied externally, is often 



MATERIA MEDICA. 591 

efficacious in inducing vomiting. Accordingly," says he, " I have 
for some years been in the habit of applying tobacco leaves to the 
region of the stomach of persons who have swallowed large quanti- 
ties of opium, and other similar articles, with a view of destroying 
themselves." It is well known, that in these cases the stomach 
is often extremely irritable, insomuch that the most powerful emetics 
have little effect in rousing that organ into action. Here, as an 
auxiliary at least, the tobacco, in the manner I have mentioned, 
is certainly very useful, and in many instances ought not to be 
neglected. 

In farther testimony of the efficacy of tobacco, externally applied, 
in the most formidable diseases, I cannot forbear inserting at length, 
a letter addressed to the editors of the Medical Museum, by a gentle- 
man of distinguished medical attainments and surgical knowledge. 
Preceding this letter, is a minute detail of the case, related by an 
Italian physician, of a young woman, long afflicted with an ab- 
dominal swelling, producing violent convulsions, which, after having 
baffled the most efficacious means, was radically cured by Dr. Cut- 
bush, senior physician of the American Marine Hospital ; at Syracuse, 
in the year 1805. 

" Sir — In consequence of the earnest solicitations of the parents 
of the young woman, whose case is above stated by one of her phy- 
sicians, she was brought to my house in Syracuse to be examined. 
I received from herself and parents a history of her case, which cor- 
responded very nearly with the above statement. Her parents in- 
formed me they had consulted thirty-three physicians and surgeons 
of Naples, and different parts of Sicily, without receiving any ad- 
vantage. Some were of opinion that the swelling was owing to a 
collection of water in the uterus ; others in the ovaria ; others, that 
it was an enlarged liver; finally, two or three were strongly im 
pressed with the idea, that it was an extra-uterine foetus, which pro 
duced all the distressing symptoms above stated. On examination, 
I found a very large swelling, extending from the epigastrium in a 
diagonal direction to the anterior spinous process of the right ilium 
The tumour had a number of inequalities on its surface; no fluctua 
tions could be felt ; she could not bear it pressed without suffering 
great pain. I must confess I did not give any decisive opinion in 
the case, it being perfectly new to me, and especially after the nu- 
merous contradictory opinions and practice of the first physicians of 
Naples and Sicily had failed in giving relief. She had been twice 
under the liberal use of mercury in Naples and Syracuse ; in the 
latter place, by the direction of a surgeon belonging to Lord Nelson's 
squadron, when his lordship was there in 1798, without beneficial 
effect. From this history and examination, I entertained no hope 
of relieving her, but the solemn entreaties of her parents determined 
me to make trial of a remedy, which I had found useful in discuss- 
ing obstinate tumours, and which finally terminated a disease that 
had been the source of great distress to the unfortunate female, and 



592 MATERIA MEDICA. 

• 

which, doubtless, proved the disease to have been an hydropic affec- 
tion of the uterus, or right Fallopian tube, though no undulation 
could be discovered. I directed the leaves of the nicotiana, recently 
collected, to be stewed in vinegar, and applied to the abdominal 
swelling. The first application produced nausea, vomiting, vertigo, 
great depression of muscular strength, copious perspiration, and a 
loose state of the bowels. Her pulse became very slow. In conse- 
quence of the violence of the above symptoms, it was not long con- 
tinued ; but on the succeeding day, it was repeated morning and 
evening, and produced all the above symptoms, but in a less degree, 
attended with an immoderate flow of water from the vagina. The 
application was continued twice a-day for one week, when its effects 
on the system were less powerful; but I was informed, with the 
most rapturous expressions, that the tumour had diminished very 
much. The day following, a priest was despatched to inform me, 
that the water was continually running from her as she walked her 
room. The remedy was continued about twenty days, but the 
swelling disappeared entirely before the fourteenth. No medicine 
was given, excepting a small quantity of opium or wine during the 
day. When the application of the tobacco was omitted, her abdomen 
was perfectly soft, and she could bear it pressed without pain. She 
was occasionally attacked with syncope, and complained of a want 
of appetite : I advised a bandage to be applied around her body, a 
course of tonic medicines, a generous diet to be gradually increased, 
equitation, (riding) and cheerful company. I saw her in October, 
1805 ; she informed me that all the functions of the body were 
natural; her countenance w T as florid and cheerful. — April 1st, 1806, 
I was informed she remained in good health. 

" It is difficult to account for the modus operandi of tobacco in 
this case, unless the violent commotion, which it excited in the sys- 
tem, ruptured the cyst which probably contained the water. I con- 
ceive the external application of tobacco, as a remedy in many 
diseases, demands more attention from physicians, than it has gene- 
rally received. In obstinate constipation of the bowels, I have 
applied tobacco stewed in vinegar or water, with the greatest suc- 
cess; even after powerful cathartics, enemata of different kinds, 
injections of tobacco smoke, or the infusion of the plant have 
failed ; and conceive it preferable, in many cases of ascites, to the 
common mode of administering it internally in the form of tincture 
or infusion. 

" I am, sir, with esteem, yours, 

EDWARD CUTBUSH," 

Happy if this plant " of many virtues" could always be exerted 
to beneficent purposes, and for which, no doubt, it was intended by 
the all- wise and benevolent Creator : but, alas ! w T e are constrained 
to deplore not only the idle and expensive, but too often fatal abuse 
of it, by snuffing, chewing, and smoking practices, which cannot be 



MATERIA MEDICA. 593 

loo severely censured, especially in young persons, and those of 
weak digestion, consumptive or delicate habits. When used in either 
of these forms, by persons unaccustomed to it3 use, it will in small 
quantities produce stupor, giddiness, and vomiting : but, like spirits, 
opium, and other narcotics, the use of it may be introduced by de- 
grees, so that its peculiar effects, even from large quantities employed, 
seldom appear. 

TOE ITCH. See Moonvort, Broad-leafed. 

TOOTHACHE TREE. See Prickly Ash. 

TOUCHWOOD, Boletus Igniarius — Called also spunk. It is 
a spongy substance, growing on the white oak, pine, and hickory 
trees, generally used for catching fire with flint and steel. The 
heart of that which grows on the oak reduced to powder, and ap- 
plied to violent hemorrhages from wounds, is said to be an excellent 
application to stop the bleeding. 

TREFOIL, WATER, Menianthes— Grows about twelve inches 
high, in marshes, swamps, and wet meadows. It bears many ele- 
gant flowers, in a spike, which are sometimes white, but are com- 
monly rose-coloured on the outside, and in the inside finely fringed ; 
the leaves are three together, resembling our garden beans. 

A drachm of the powdered leaves is said to operate up and down. 
An infusion of the leaves, two hands full to a quart of boiling wa- 
ter, in doses of a tea-cupful two or three times a-day, is esteemed a 
useful medicine in chronic rheumatism, in scorbutic complaints, and 
in all impurities of the blood. 

TULIP-BEARING POPLAR. See Poplar, White. 

TURMERIC. See Blood Root. 

UNICORN ROOT, Aletris Farinasa — Grows in meadows, and 
on the sides of mountains, about six or seven inches high ; leaves 
spear-shaped, lying on the ground, and are green all the winter. 
The flowers grow on the stalk from the ground, which hang clown at 
the top when fully blown ; the root is whitish, full of small fibres, about 
the thickness of the end of the little finger, and crooked at the end. 

The powdered root, in doses from half to a tea-spoonful, is said to 
afford relief in hysteric and flatulent or wind colic. A large handful 
of the root steeped in a quart of spirits, in doses of a wine-glassful 
three times a-day, is highly esteemed by some as a valuable remedy 
in chronic rheumatism. 

VALERIAN, WILD, Valeriana Officinalis — Grows abundantly 
in the vicinity of the Ohio river. It rises two or three feet high ; the 
75 



594 MATERIA MEDICA. 

leaves in pairs, large, hairy, and of a dusky green colour ; flowers 
stand in large tufts on the top of the branches, of a pale whitish-red 
colour. 

The root, which is the part used in medicine, consists of a num- 
ber of slender fibres, matted together, and attached to one head, of a 
brown colour, having a strong and unpleasant smell. Valerian has 
long been recommended by the most learned physicians as a medi- 
cine of great use in nervous disorders ; and is particularly serviceable 
in hysteric cases, as well as in epilepsy, proceeding from a debility 
of the nervous system. According to Dr. Withering, it is an excel- 
lent medicine in cases of habitual costiveness. It should be given 
in doses from one to two tea-cupsful or more, in powder, three 
times a-day. It seems most useful when given in substance, and in 
large doses. 

VINE, GRAPE, Vitis Vinifera. — Several species of this valuable 
shrub grow in the United States. The success which has attended 
the attempts to cultivate foreign and native grapes, sufficiently proves 
that our climate is perfectly congenial to the cultivation of the vine, 
and that, with very little attention, we might supply ourselves abun- 
dantly with cheap and wholesome wines. 

Wine certainly is most excellent to prevent, as well as to cure, 
diseases. A prudent use of it, when genuine, I can say, from my 
own experience and observation, admirably conduces to health. It 
will be found particularly beneficial to the weak and aged, and to 
those who are exposed to a warm and moist air, or to a corrupted 
one. It exhilarates the spirits, quickens the circulation, promotes di 
gestion, invigorates both the body and mental faculties, and thereby 
renders persons less susceptible to disease. 

As a medicine, wine is a most grateful and valuable cordial in 
languors and debility, in which it is found to raise the pulse, support 
the strength, promote perspiration, and resist putrefaction. Hence, 
we cannot appreciate too highly this reviving liquor, which justly 
merits the title of " donum Dei," gift of God. Were we to have less 
recourse to ardent spirits, and instead of continuing in those abomi- 
nable practices of drinking before dinner, to take a few glasses of 
wine after dinner, we should find " our account " in it. During my 
long residence in Savannah, and exposed as I was alternately by 
my professional pursuits, to the scorching sun and chilling night air, 
I was never attacked with the prevailing fever incident to that cli- 
mate, which I ascribe almost entirely to the daily use of the purest 
and best wine. In farther corroboration of this fact, I will with can- 
dour state, that, when from unforeseen reverses of fortune, I was in- 
duced to remove to the more healthy situation, as I thought, of 
Washington, not a season has elapsed, but some one or other of my 
family has suffered severely with the bilious or nervous fever, which 
I cannot but ascribe, in a great measure, to our not drinking such 
good wine as we were accustomed to at the southward. 



MATERIA MEDICA. 595 

There are many persons in good circumstances, who ohject to the 
daily use of wine, as being too expensive. To such I would recom- 
mend it as economy. Besides the very great satisfaction which 
would naturally flow from having a healthy family, money is often 
saved by a prudent use of it. To illustrate this, it is only necessary 
to state, that several families at the southward, who were in the habit 
of paying annually large accounts for medical attendance, inquired 
of me how it was, that myself and family enjoyed such perfect 
health, while they were sickly. I remarked, that it was principally 
owing to drinking good wine, and assured them, though against my 
interest, if they would but pursue my plan, they also would enjoy 
good health. Some of them adopted my plan, which carried con- 
viction with it; for on the following year, and afterwards, they 
enjoyed much better health, were enabled to attend to their busi- 
ness, and found the expense of the wine saved in their physcian's 
bill. 

Others again, object to the habitual use of wine, as not congenial 
to their constitution, observing that whenever they entertained, or 
dined with, their friends, they were induced, either from politeness 
or persuasion, to drink as the rest of the company,* from which their 
heads were uniformly affected, and they always felt disagreeable on 
the following day. This objection is at once refuted, by simply 
stating, it is my wish to impress on my readers the use but not the 
abuse of wine, which no man more heartily than myself abhors, es- 
pecially in young persons, whose readiness to take glass for glass 
with their elders, is to me one of the most lamentable spectacles in 
nature. The excessive use of this stimulant, as well as every other, 
is most certainly injurious to the system, and ought, therefore, to be 
carefully guarded against by every rational person. 

It deserves also to be noticed, that the same quantity of wine 
which would produce intoxication in one person, would have little 
or no effect on another; and there is also a wide difference between 
taking it on an empty stomach and a full one. One glass, taken 
an hour or two before dinner, will affect the head, in most cases, 
more than a pint after dinner. In like manner, a half pint of adul- 
terated or impure wine, will produce unpleasant sensations, when a 
pint of genuine Madeira will have no other than the pleasing effect 
of invigorating the constitution. The apprehension which some per- 
sons entertain, that children, early accustomed to wine, will be apr 
to become drunkards, is without the smallest foundation whatever. 

* The following anecdote will at once show the absurdity of pressing out 
friends to drink more wine than their appetites crave. A foreigner was invi- 
ted to a party, consisting, as he was told, of English philosophers, of whom 
he conceived a great deal. After a very plenteous dinner, the cloth was 
cleared, and the bottles were placed on the table. He was pressed after rive 
glasses to drink on, but the the stranger persisted in assuring the company, he 
felt no drought. These philosophers began to be angry, and the foreignei 
rang the bell, and insisted on another course, - r they ought as much to eat, 
as he to drink, against inclination. 



596 MATERIA MEDICA. 

On the contrary, it is a lamentable truth, that we daily see per- 
sons, who were restrained in the early period of their lives, from 
drinking wine, toddy, or table drink, in the presence of their parents, 
become perfect sots after they arrive at the age of manhood. It is 
one of the greatest commendations of wine, that we never see those 
who daily indulge the use of it become drunkards. This is verified 
not only in France, but in many parts of our Union. In Charles- 
ton, Savannah, and Augusta, the inhabitants generally make use of 
wine; the consequence of which is, they are sober, discreet, and not- 
withstanding the climate, are healthy. It is a rare thing indeed to 
see a drunkard of any description in the streets of those cities. 
Whether it be owing to drinking less of ardent spirits, or a better po- 
lice, I will not pretend to say; but it is the fact, and would that I 
could, with equal propriety, make the same remarks of the metro- 
polis of the United States, where drunkenness, among the lower class 
and negroes, reigns triumphantly, throwing open, as it were, the 
gates of every species of vice. 

Vice is a monster of so frightful mien, 

As, to be hated, needs but to be seen; 

Yet seen too oft, familiar with her face, 

We first endure, then pity, then embrace. — Pope. 

It is also worthy ot remark, that among the genteel circles in 
Charleston, Savannah, and Augusta, you will hardly meet with an 
instance of a gentleman drinking any thing before dinner, or press- 
ing his friends to take more wine after dinner than they feel an in- 
clination for ; however, this is only what might be expected of those 
not excelled by any society on earth, either for polished manners or 
true hospitality. " Experientia docet," experience teaches, is my 
motto, and as I speak from this alone, I feel conscious of the recti- 
tude of my heart, in earnestly recommending to my fellow-citizens, 
both old and young, the daily and prudent use of genuine wine, at 
least during the sickly season, and in unhealthy situations, without 
any fear whatever of becoming sots. That the tenderest infant may 
be benefitted by it, I am convinced from my own practical observa- 
tions; but if higher authority be required, I will conclude with the 
following sentiment of the late Professor Rush : — 

" It is remarkable," says he, " that the children of persons in easy 
circumstances, who sip occasionally with their parents, the remains 
of a glass of wine after dinner, are much less subject to disease, than 
the children of poor people, who are without the benefit of that arti- 
cle of diet." 

Having said so much in praise of the generous juice of the grape, 
and considering it, as I sincerely do, one of the choicest medicines 
in the Materia Medica, I cannot do otherwise than present my 
readers with the following most approved method for making Ameri- 
can wines, taken from the Domestic Encyclopedia, as well as the 
mode of detecting adulterated wines. 



MATERIA MEDICA. 597 

Grapes must be fully ripe before they are gathered ; gather them 
in a fair day, when they are perfectly dry ; and take away all the 
rotten and unripe grapes, for they spoil the wine. If your vintage 
be large, and you gather more grapes than you can mash and press 
out in one day, let them be gathered without bruising, for bruised 
grapes soon attract an unsavoury taste, and hurt the wine ; however, 
if they be mashed the same day they are gathered, the bruising will 
do no hurt. 

Chaptal advises to cut of the tails of grapes very short with a pair 
of scissors, and to choose none but sound grapes, and those clusters 
which are best exposed, rejecting those which have been sheltered, 
and near the ground, and to prefer those which ripen at the bottom 
of the vines. They are then to be put into small baskets to prevent 
the loss of juice, by the superincumbent weight ; and when full they 
ought to be put in carts, or on the backs of men or horses. 

I would advise the gathering of them to be directed by some grave 
discreet person ; for as this work is done generally by servants and 
children, it is made matter of pastime and frolic, and many grapes 
are torn off, and either bruised or scattered on the ground, to the no 
small damage of the owner, both in the loss of fruit and in hurting 
the wine. These things should be impressed on the minds of the 
gatherers before they begin, that every thing may be done regularly 
and in order, by which means more work will be done, and to much 
better purpose. 

If white frosts happen before some of your grapes are fully ripe, 
let them still hang on the vines, and they will grow ripe, rich, and 
high-flavoured ; but they must be gathered before the weather be 
so hard as to freeze the grapes, for that will spoil them : the light 
frosts that only kill the leaves do not hurt the fruit, unless it be such 
as are late ripe ; these should be carefully covered from all frosts, 
they should grow against walls or board fences fronting the south or 
south-east, and at night be covered with mats or frames thatched 
with straw, which should be so contrived as to be set up to cover the 
fruit or let down at pleasure. 

As the wine made from black grapes has a different management 
from that made of w T hite grapes, I shall begin with the white ; these 
then must be gathered, as I mentioned before, in a fair day, when 
the grapes are perfectly dry ; and both the rotten and the unripe 
grapes carefully plucked off from every bunch ; the clusters are then 
thrown into the mash vat, and two or three men, according to the 
quantity, having Avashed their feet and legs very clean in bran and 
water, get into the vat and trample and mash the grapes thoroughly, 
so that none escape. 

Chaptal says, as a general rule, that the grapes must be equally 
pressed, to ensure a uniform fermentation: and the vat filled in 
twenty-four hours, to avoid the inconvenience and imperfections 
arising from a successive series of fermentations, and when unex- 



598 MATERIA MEDICA. 

pected rain suspends the collection of the grapes, the juice of those 
already collected and placed iu the vat, must ferment separately. 

The first and second pressing being mixed together, is put into 
hogsheads, and filled within four inches of the bung, that it may 
have room to work and ferment, the casks placed in some warm 
room or dry cellar. Then having a small spile fixed in the middle 
of the head of the cask, the third or fourth day, draw a little of the 
wine in a glass, and if it be pretty fine, draw it off immediately into 
a clean, dry, well-scented cask, the larger the better, so you have 
wine enough to fill it, which you must, do within two inches of the 
bung, and stop it closely, leaving only the vent hole open for a se- 
cond fermentation ; after a few days it will work a second time, but 
not so much as at the first; if your wine be strong and good, which 
you ma}^ know by the age of your vineyard, and by the goodness of 
the seasons, it will be best to leave the bung-hole open for this se- 
cond working ; the wine will be the better, for strong wines require 
a greater fermentation than weak wines; and the stopping of the 
bung-hole checks the working, and prevents weak wines from spend- 
ing themselves too much ; on the contrary,, if strong wines have not 
a thorough working, they are apt to grow thick and ropy ; by this 
you may form a proper judgment what degree of fermentation is 
proper for the wine that is under working, and govern yourself ac- 
cordingly. Three or four days after the second fermentation begins, 
carefully watch your wines every day, again try them in a glass, 
and if they be pretty fine, prepare a cask sweet and good, burn a 
good large brimstone match in it, and as soon as the match is burnt 
out, whilst the cask is full of smoke draw off the wine into it; now 
fill up your cask to the brim, and bung it up tightly, and stop the 
vent-hole ; the smoke of the brimstone will hinder any farther fer- 
mentation ; and this is called stunning or sulphuring; then make a 
mortar of clay, and horse dung, mixed up with strong flax-seed jelly, 
covering the bung and vent-hole close with it, let it stand till it is fit 
for use. 

When you first rack off, if you have any old wine that is rich and 
good, of the same kind or colour, put four or six gallons of it and two 
gallons of good brandy, into your cask ; this quantity is sufficient for 
an English hogshead, and then rack off your wine into it for the first 
time ; this will greatly strengthen and preserve it. 

When wine is in fermentation, all the gross parts are thrown up 
to the top of the cask or vessel that it ferments in, and there meet- 
ing the air thej^ contract a harshness. If then they be suffered to 
pass down through the body of the wine, which they certainly will 
do as soon as the fermentation is over, they will communicate those 
evil qualities to the wine. For this reason, draw off your wine both 
times before the fermentation be quite over. — These general rules 
are of great consequence. 

I now pass on to the making of red wine from the black grapes. 
Red wines have a different management from the white ; the whole 



MATERIA MEDICA. 599 

of one or even two days' treading or mashing, where the vintage is 
great, is thrown into a large vat, the must, stalks, skins and all, and 
stands in some warm dry place or cellar. The vat is covered close 
with sheets or blankets, or both, and thus it remains according to 
custom, from four to seven or even ten days, according to the cold- 
ness or heat of the weather. This is done to obtain a strong fermen- 
tation, in order to give a deeper colour to the wine ; and this is the 
only end proposed by it ; the manager of this work visits the vat 
twice a-day, and in a glass views the colour of the wine, and tastes 
it ; if the tincture be not deep enough to his mind, he knows by the 
taste of the wine, whether it will stand a longer fermentation ; if it 
will not, he contents himself with the colour it has, and draws and 
presses it off, and fills it into casks leaving about two inches from the 
bung, for a second fermentation. When the second fermentation is 
over, which generally happens in four or five days, he draws it off 
into clean well-scented casks, and adds to it six gallons of good old 
wine and two gallons of brandy to an English hogshead, which con- 
tains from sixty to sixty-three gallons. Where the same kind of 
wine is not to be had, he makes use of port wine. He then fills the 
cask quite full, and bungs it up tightly, leaving only the vent hole 
open to let out the generated air. Note : when I say, where the 
same kind of wine is not to be had, he makes use of Portugal wines, 
it is mentioned for our practice, not that the French make use of 
such wines, for they always have wines enough of their own of the 
same kind. 

Besides the main pulp or core of the grape, which is white in 
black grapes as well as others, there sticks to the inside of the skin, 
a considerable body of rich pulp, of a deeper dye in some than in 
others. This pulp gives the colour to the grape: this same pulp also 
gives the colour to the wine, for the same grape is capable of 
making white wine as well as red toine ; if the main core which is 
first trod out, be only used, the wine will be white ; but if the red 
pulp be mixed with it, it makes it of a rich purple colour : as this is 
a clear case, the great point of improvement is, to dissolve or extract, 
this rich pulp without injuring the wine. — That the present method 
is the best and most effectual to that purpose, I can by no means 
think ; the violent fermentation through which the wine is made to 
pass, in order to procure the tincture, must exhaust the spirits in a 
very great degree, and leave the body in a weak and languid state, 
and subject it to harshness, to turn meagre or vapid in a short time ; 
I think I have reason to conclude, that if the husks or skins, after 
four days lying in the murk, were taken out, and thrown into the 
mash vat, and trod over again, and especially if some of the must, or 
rather wine, be now and then thrown over the husks, in order to 
wash away the pulp, that a full tincture may be obtained, without 
torturing the wine, as the present manner is, and without running so 
great a risk of spoiling it. 



600 MATERIA MEDICA. 

Another method, by Joseph Cooper, Esq. of Gloucester county, 
New Jersey. — I put a quantity of the comb from which the honey 
had been drained, into a tub, and added a barrel of cider, immedi- 
ately from the press : this mixture was well stirred, and left for one 
night. It was then strained before a fermentation took place ; and 
honey was added till the strength of the liquor was sufficient to bear 
an egg. It was then put into a barrel ; and after the fermentation 
commenced, the cask was filled every day, for three or four days, 
that the filth might work out at the bung hole. When the fermen- 
tation moderated, I put the bung in loosely, lest stopping it tightly 
might cause the cask to burst. At the end of five or six weeks, the 
liquor was drawn off into a tub, and the whites of eight eggs, well 
beaten up, with a pint of clean sand, were put into it : I then added 
a gallon of cider spirit; and after mixing the whole well together, I 
returned it into the cask, which was well cleansed, bunged it tightly, 
and placed it in a proper situation for racking off, when fine. In the 
month of April following, I drew it off into kegs, for use, and found 
it equal, in my opinion, to almost any foreign wine: in the opinion 
of many judges, it was superior. 

This success has induced me to repeat the experiment for three 
years ; and I am persuaded, that by using clean honey instead of 
the comb, as above described, such an improvement might be made, 
as would enable the citizens of the United States to supply them- 
selves with a truly federal and wholesome wine, which would not 
cost a quarter of a dollar per gallon, were all the ingredients pro- 
cured at the market price ; and would have this peculiar advantage 
over every other wine, hitherto attempted in this country, that it 
contains no foreign mixture, but is made from ingredients produced 
on our own /arms. 

Adulterated Wines. — Wines may be adulterated by a variety of 
substances. The object proposed to be accomplished by this fraud, 
is to mask some of their defects, and to give them colour, odour, or 
strength. Among the substances employed, there are some, the use 
of which is attended with no danger ; others on the contrary are more 
or less poisonous, and cannot be swallowed without giving rise to 
serious accidents, which may often be followed by death. This 
consideration has induced us to state the method whereby it may be 
determined, whether the wine has been adulterated. 

Sugar of lead, cerusse, and still more frequently litharge, are 
mixed with acid or sharp-tasted wines, in order to render them less 
so, and these substances do, in fact, give them a sweet taste. Of all 
frauds this is the most dangerous. 

White ivines, adulterated by preparations of lead, offer, indepen- 
dently of their saccharine astringent taste, many properties by which 
we may detect them. They redden but slightly the tincture of 
litmus, because the acid they naturally contain is saturated by the 
oxide of lead. Sulphuric acid (oil of vitriol) and the sulphates, (or 
salts formed by the union of sulphuric acid,) such as the sulphate of 



MATERIA MEDICA. 601 

soda, (Glauber's salts,) sulphate of magnesia, (Epsom salts,) dis- 
solved in pure water, and mixed with these wines, render them 
thick and muddy; in a short time a white precipitate is found at the 
bottom of the vessel in which the experiment is made. The de- 
posite does not disappear upon the addition of water. Muriatic acid 
and the muriates, as the muriate of soda, (common salt,) when 
dissolved in pure water, and added to adulterated wine, also occasion 
a heavy white precipitate, which may be dissolved in twenty-five 
or thirty times its weight of water. The sub-carbonates of soda, 
potash and ammonia, act in the same manner. The white pre- 
cipitate they throw down is insoluble in water, but is dissolved 
in a very singular manner by pure nitric acid. The chronic acid, 
and the cromate of potash, occasion a precipitate of a very fine 
Canary yellow colour. Sulphuretted hydrogen, and the hydro- 
sulphates, as liver of sulphur, turn white wines sophisticated with 
lead of a black colour, and at the end of a few minutes throw down 
a black deposite. — If we collect upon a filter, and dry the precipi- 
tates obtained by the means just indicated ; and if, after having 
mixed them with powdered charcoal and caustic potash, we expose 
them in a crucible to a red heat, during half an hour, we obtain a 
metallic button easy to be known ; first, by its deep blue colour ; 
secondly, by the facility of marking it with the nail ; thirdly, by the 
quickness with which it is dissolved in aqua-fords, forming thereby 
a liquid salt of a sweetish taste, and having the property of being 
precipitated of a white colour by the sulphates, the hydro-chlorates, 
and the carbonates. Pure potash, soda, and the volatile alkali mixed 
with these wines, cause a white precipitate. Evaporated in a cap- 
sule at a boiling heat, they leave a deposite, which, being heated to 
redness with powdered charcoal, furnishes, at the end of thirty or 
forty minutes, metallic lead. This property is sufficient to prove 
the presence of lead in wines. 

Red icines, when adulterated with the preparations of lead, are 
never of so deep a colour as before the adulteration ; they are of a 
pale red. We may prove the existence of lead in red wines, by the 
aid of the substances directed to be used for white wines. It is, 
however, necessary to observe, that ammonia causes a dirty green- 
coloured precipitate, when mixed with red wines which contain 
lead ; on the contrary, in white w r ines the precipitate is white. That 
the hydro-sulphates may lead us into error, if we confine ourselves 
to the superficial examination of their action. That these substances 
detect the presence of lead in red wines, by throwing down a black 
precipitate, is true, but the same substances, when mixed with the 
greater parts of red wines, produce the same effect ; they become 
dark, and finish, by depositing flakes of a deep violet colour. It is 
necessary then, when we wish to decide upon the test furnished by 
the hydro-sulphates, to add that, the black precipitate they form, 
when mixed with red wines, indicates the presence of lead, if, after 
7(3 



602 MATERIA MEDIC A. 

having been dried upon a filter, and calcined with potash and char- 
coal, it leave a button of metallic lead. 

Wines adulterated by Alum. — The object of this adulteration is 
to render the wines redder and less changeable ; and to give them 
an astringent taste. The danger of this fraud is generally known, 
digestion becomes painful, vomiting from time to time, obstruction 
of the bowels, and piles, are the result of drinking wines thus adul- 
terated. Of all the methods proposed to discover the presence of 
alum in wine, the following appears to merit the preference. By 
evaporating several pints of wine we observe a reddish mass, com- 
posed of alum, and the colouring matter and tartar, which make a 
part of the wine. This mass being dissolved in a large quantity of 
water, and made to boil with some charcoal of the linden tree*, a 
liquid almost without colour is obtained. If the liquid be filtered, 
and then evaporated by a gentle heat, until a thin crust be formed 
upon the surface, and set in a cool place, the tartar will crystallize 
and the supernatant fluid will hold the alum in solution. This fluid 
ought to have a sweetish astringent taste, and throw down a white 
precipitate, upon the addition of ammonia, or caustic potash ; that 
formed by this last body ought to be soluble by an excess of 
potash. A solution of barytes, its acetate or muriate, ought to render 
it thick and occasion a white precipitate, insoluble in water and 
nitric acid. 

Wines adulterated by Chalk. — Some persons are in the habit of 
adding chalk or lime to red or white wine, having a disagreeable 
acidity, with a view of saturating the acetic, or tartaric acid, and 
thus by the combination of the chalk or lime with the acid, destroy 
their sharp taste. Wines treated in this manner are really much 
safer, but they may give rise to disagreeable symptoms if they con- 
tain too great a quantity of the acetate of lime. This fraud may be 
discovered by the following means : — Evaporate a quantity of the 
wine in an open vessel, or if the spirit be desired, let it be distilled : 
when the fluid is reduced to the consistence of a syrup, add a few 
ounces of distilled water, agitate the mixture for ten or twelve min- 
utes and filter the liquid, which will be found to contain acetate of 
lime, formed by the acetic acid of the wine, and the lime or chalk 
which has been added. The tartar which the wine contained will 
not be dissolved, but will remain upon the filter. 

VIOLET, RATTLESNAKE— Grows about four inches high, 
on the banks of rivers, and in pine woods ; leaves grow in a cluster 
from a stalk, oval-shaped, fleshy, and full of small veins; flowers of 
a pale blue colour. 

An infusion of this plant, a handful to a quart of boiling water, 
taken in doses of a tea-cupful three or four times a-day, and some of 

* Or any fresh-made charcoal. 



MATERIA MEDICA. 603 

the green leaves bruised, and applied twice or thrice a-day to scrofu- 
lous tumours, or king's evil, is said to be an infallible remedy. 

YIOLET, SWEET, Viola Odorata— Is cultivated in our gar- 
dens ; leaves heart-shaped, notched, flowers deep purple, odoriferous. 

A tea-spoonful of the powdered herb is celebrated as a mild laxa- 
tive. To children, a strong infusion or decoction formed into syrup 
with molasses, honey, or sugar, in doses of a wine glassful, will be 
more acceptable. 

YIRGIN'S BOWER— Grows about two feet high, near ponds 
and low pastures; leaves opposite in pairs, and terminated by an odd 
one; the flowers somewhat resemble the appearance of feather tails. 

A small handful of the leaves infused in a quart of boiling water, 
and given in doses of a gill three times a-day, is said to be very bene- 
ficial in venereal sores, or cutaneous eruptions of long standing, 
particularly if the sores be washed with the same. The bruised 
green leaves have been applied to ulcers, as an escharotic, to destroy 
fungous or proud flesh. 

VIRGINIA, OR BLACK SNAKE ROOT, Serpentaria Vir- 
giniana — Grows in rich woodlands, from seven to nine inches high, 
leaves heart-shaped, flowers of a purplish brown colour. The root 
is composed of a number of strings, or fibres, issuing from one head, 
and matted together, of a brownish colour on the outside, and pale 
or yellowish within. 

It has an aromatic smell, and a warm, bitterish, pungent taste. 
It promotes perspiration, raises the pulse, and resists putrefaction. 
Hence it is especially adapted to the low and advanced stage of 
typhus or nervous fever. It may be given in the form of infusion 
or tea, a handful to a quart of boiling water, in doses of a tea-cupful, 
or in powder, from ten to thirty grains every two or three hours. 
Conjoined with the Peruvian bark, or any of its substitutes, it is an 
admirable remedy in obstinate cases of the ague and fever, and other 
disorders of general weakness. In cold phlegmatic habits, it has 
also been exhibited in the form of tincture, and. when united with 
double the quantity of dogwood bark, or berries, it affords a good 
bitter. Professor Barton observes, that a strong decoction of the root 
was used with great benefit as a gargle in a putrid sore throat, which 
prevailed in New Jersey. 

In that species of pleurisy, which is properly enough designated 
by the epithet bilious, Professor Chapman states, he has repeatedly 
had occasion to recur to the serpentaria, and always with more or 
less utility. This bilious pleurisy he considers as having all the 
characteristics of pneumonic inflammation, with the addition of some 
of the symptoms incident to autumnal fever, such as headache, great 
gastric distress, and almost always violent vomitings of bile. It dif- 
fers, also, from ordinary pleurisy, in having less activity of inllam- 



604 MATERIA MEDICA. 

mation, and consequently in not bearing the same extent of deple- 
tion. The system, indeed, will often be very evidently depressed 
by one or two bleedings. In this case, the practice which has been 
commonly pursued is, after the removal of a comparatively small 
portion of blood, and the thorough evacuation of the alimentary ca- 
nal, to administer very freely draughts of the infusion of the serpen- 
taria, in order to excite perspiration. 

Externally applied, the decoction has been found to cure the itch. 

WAKE ROBIN. See Cuckow Pint. 

WALNUT, WHITE, Juglans Alba— Affor&s one of the finest 
cathartic medicines in the whole American Materia Medica. The 
inner bark, boiled for several hours, then strained and reboiled to the 
consistence of thick honey, forms the best preparation of this invalu- 
able medicine. A common-sized pill or two, at going to bed, is ad- 
mirable to remove those costive habits, which occasion headaches, 
loaded stomachs, colics, &c. And, in increased doses, saj^ double 
quantities, it will be found a sovereign medicine in dysentery, bilious 
fever, and all other complaints requiring aperient medicines, more 
especially if combined with equal quantities of calomel. I cannot 
quit this extract without most heartily recommending it to every 
American family to keep it constantly by them. 

The bark of the root is excellent to raise a blister, therefore, may 
be substituted for Spanish flies. 

WATER CRESSES. — Grow in running brooks and wet ditches. 

The green herb, eaten as a vegetable, and the expressed juice in 
doses of a table-spoonful two or three times a-day, is an effectual re- 
medy for the scurvy. 

WATER TREFOIL. See Trefoil, Water. 

WHITE BRYONY — Grows in low meadows and swamps ; the 
stems twist about bushes, and shoot out to a great extent ; the leaves 
pointed, irregularly toothed, very large, diminishing gradually to the 
top ; flowers of a yellow green, which produce a red berry ; the root 
is white and large. 

A very strong decoction of the root strained, and then simmered 
slowly by the fire, until it become of the consistence of honey, is 
said to be a good purgative medicine in doses from one to three tea- 
spoonsful. 

WHITE WOOD. See Poplar. 

WILLOW, Salix — Professor Barton thinks that our willows pos- 
sess nearly the same virtues that have been ascribed to those of Eu- 
rope, and that they might be substituted for the Peruvian bark. The 



MATERIA MEDICA. 605 

bark of the white willow, smooth willow, and crack willow, so called 
from the remarkable brittleness of its branches, collected when it 
abounds with sap, has been successfully employed in intermittent or 
ague and fever, in doses of one or two drachms. The broad-leafed 
willow is said to possess greater virtues than either of the above. 
This species may be distinguished by the shape of its leaves from all 
others, except the bay-leafed willow. The leaves of the latter are 
smooth and shining, of a deeper green, and have not the downy ap- 
pearance on the under surface, which is so remarkable in this. It 
is found in woods and hedges, on hilly situations, and delights in 
cold clayey moist grounds. 

A strong decoction of this bark resembles port wine in colour. It 
is astringent to the taste, and somewhat bitter. According to Dr. 
Wilkinson, it is a remedy of great efficacy in most cases where the 
Peruvian bark is indicated. He directs one ounce and a half 
(a handful) of the bark to be infused in one quart of water for six 
hours, then boil it over a gentle fire for a quarter of an hour, and 
strain for use. Of this the ordinary dose is a wine-glassful three or 
four times a-day. But in ague and fever, the dose may be repeated 
every third hour in the interval of the fit. 

WINTERBERRY. See Alder, Black. 

WINTERGREEN. See Calico Tree. 

WOOD BETONY— Grows about a foot high in upland woods, 
and old pastures ; the stem square and hairy; the leaves opposite, and 
hairy, the flowers in spikes, of a purple colour. 

An infusion of the herb, a handful to a quart of boiling water, in 
doses of a tea-cupful every two hours, is said to be serviceable in 
rheumatic or gouty affections. 

WORMSEED. See Jerusalem Oak. 

WORMWOOD. See Mugwort. 

YARROW — Grows in dry pastures and along the sides of fences, 
about a foot high ; leaves pointed ; flowers white, tinged with a little 
purple beneath. 

A handful of the tops of yarrow, infused in a quart of boiling wa- 
ter, in doses of a tea-cupful three or four times a-day, is reputed to 
be a valuable medicine in the dysentery, bleeding piles, and re- 
straining immoderate flow of the menses. A table-spoonful of the 
expressed juice taken twice a-day, and the herb bruised; or in the 
form of a poultice, is said to have cured a cancer of the breast. The 
green leaves pounded, and applied over a bruise, dissipates it in a 
few days. 



606 MATERIA MEDICA. 



DIRECTIONS 



RESPECTING THE. COLLECTION AND PRESERVATION OF VEGETABLE 

SUBSTANCES. 



Herbs and leaves are to be gathered in dry weather, after the 
dew is off them, and are to be freed from decayed, withered, or for- 
eign leaves. They are usually tied in bundles, and hung up in a 
shady, warm, and airy place, or spread upon the floor, and frequently 
turned. If very juicy, they are laid upon a sieve and dried by a 
gentle degree of artificial warmth. They should be dried in such 
quantities at a time that the process may be finished as quickly as 
possible; for by these means their powers are best preserved ; the test 
of which is, the perfect preservation of their natural colour. 

Flowers ought also to be collected in clear dry weather, after the 
dew is off, immediately after they have opened. They should also 
be dried nearly as leaves, but more quickly, and with more atten 
tion. As they must not be exposed to the sun, it is best done by a 
slight degree of artificial warmth. 

Barks and woods should be collected when the most active part 
of the vegetables are concentrated in them, which happens in spring 
and in autumn. Spring is preferred for resinous barks, and autumn 
for those that are gummy. Barks should be taken from young trees, 
and freed from decayed parts, and all impurities. 

Seeds and fruits are to be gathered when ripe, but before they fall 
spontaneously. 

Roots which are annual, should be collected before they shoot out 
their stalks or flowers. Those which are worm-eaten or decayed are 
to be rejected. The others are immediately to be cleaned with a 
brush and cold water, letting them lie in it as short a time as possi- 
ble; and the fibres and little roots, w T hen not essential, are to be cut 
away. Roots which consist principally of fibres, and have but a 
small top, may be immediately dried. If they be juicy and not aro- 
matic, this may be done by a moderate heat; but if aromatic, by 
simply exposing them, and frequently turning them in a current of 
cold dry air. If very thick and strong, they are to be split or cut into 
slices, and strung upon threads ; if covered with a tough bark, they 
may be peeled fresh, and then dried. Such as lose their virtues by 
drying, or are directed to be preserved in a fresh state, are to be kept 
buried in dry sand. 



MATERIA MEDICA. 607 

The proper drying of vegetable substances is of the greatest im- 
portance. It is often directed to be done in the shade, and slowly, 
that the volatile and active particles may not be dissipated by too 
great heat ; but this is an error, for they always lose infinitely more 
by slow than by quick drying. When, on account of the colour, 
they cannot be exposed to the sun, and the warmth of the atmos- 
phere is insufficient, they should be dried by an artificial warmth less 
than 100 degrees of Fahrenheit, and well exposed to a current of 
air. When perfectly dry and friable, they have little smell ; but af- 
ter being kept some time, they attract moisture from the air, and re- 
gain their proper odour. 



THE NURSE'S GUIDE 



No radiant pearl, which crested fortune wears, 

No gem, that twinkling hangs from beauty's ears, 

Not the bright stars, which night's blue arch adorn, 

Nor rising sun, that gilds the vernal mom, 

Shine with such lustre as the tear that breaks 

For other's wo, down virtue's manly cheeks. — Darwin. 

Indigent Sick. — Having in my professional duties so often 
witnessed the most grievous sufferings of the sick for want of 
suitable nourishment, and this occurring too, not unfrequently in re- 
spectable families who have been reduced in circumstances, I feel it 
my duty, since it is not foreign to the subject, to call the attention 
of those in affluence, throughout our numerous cities and extensive 
country, to extend the arm of charity to the indigent sick, in their 
respective neighbourhoods. While feasting in their own houses, let 
them listen to the voice of humanity, and not forget the " house of 
mourning," where the lone widow and her orphans pine in sick and 
starving solitude. 

It is not easy to estimate the good which may be done to suffering 
humanity by beneficent acts of this kind. 

What a treat to the sick, instead of coarse food, to have a com- 
fortable bowl of soup, arrow root, sago, panado, or custard ! — And 
what a cordial, to a person labouring under protracted disease, in- 
stead of simple water to have a glass of good porter, ale, cider, or 
wine, which nature craves in this exhausted state. It is a well 
known fact, that a rarity sent unexpectedly has often been the 
means of recalling long lost appetite, and thereby rescuing from an 
untimely grave a valuable life. Indeed, there cannot be a greater 
object of charitable commiseration than a person confined to the bed 
of sickness, without the means of obtaining suitable nourishment. 
Nor are the indigent alone the grateful receivers ; for in the houses 
of the wealthy a real good sick cook is rarely met with ; and many 
who possess all the goods of fortune have attributed the first return 
of health to an appetite excited by what is called good kitchen physic. 
How important an advantage in overcoming disease is a nutritious 
diet ! Nor is this the only good to be derived from acts of charity 



THE NURSE'S GUIDE. 609 

for we have frequently seen a fond mother denying herself the ne- 
cessary quantity of food that she might the better provide for her sick 
children, reduce that strength upon which the welfare of her family 
essentially depends. 

In faith and hope the world will disagree, 

But all mankind's concern is charity ; 

All must be false that thwart this one great end, 

And all of God, that bless mankind, or mend. — Milton. 

In the preliminary observations of this work {Seepages 32 and 33) 
we stated facts illustrative of the important advantages resulting from 
good nursing and dieting. The frequent occurrence of fatal effects 
when this is neglected, imperiously demands that I should present 
to my readers the most approved rules which ought to be understood 
by every nurse, as well as to exhibit the mode of preparing such 
aliments as are most proper for the sick; in order that the tram- 
mels of ignorance in nurses, if possible, may be broken, and sim- 
plicity of diet and general management become an increased object 
of our attention. 

But trust me, when you have done all this, 
Much will be missing still, and much will 
"Be amiss." — Milton. 

Duty of a Nurse. — Before we proceed farther on this subject, 
it may be necessary to observe, that none should be nurses unless 
they possess honesty, sobriety, and fidelity. The more equal and 
cheerful they are in their disposition, the better, provided they keep 
at their proper distance, and never incommode the patient with idle 
chit chat, or any thing that can occasion sudden alarm. The)^ ought 
to be expert in the execution of their office, yet without bustle or 
noise ; the track being easily kept when once got into, and the objects 
to be attended to but few. 

" To watch the " afflicted" with anxious care,, 
The lurking symptoms of disease detect, 
And with the aid of sweet nutritious food. 
Or potent herb, or kindly drug, to aid 
Oppressed nature in her arduous task 
Be thine ! and thine the grateful rich reward 
Of conscious duty done — a meed more fair 
Than all the laurels which bedeck the brow 
Of modern Caesar." 

The office of a nurse, however trifling it may appear, if well 
known and rightly performed, is unquestionably of great benefit to 
mankind. To prove this fact it is only necessary to appeal to every 
skilful physician, whether, when the plan prescribed by him lias 
been punctually observed, he has not commonly seen the disease 
either yielding readily to the remedies, or terminating in its usual 
period, without any mysterious or difficult symptoms arising through 
77 



610 

the course of it. Whereas, on the contrary, when his plan has been 
altered, as for instance, when the medicine has not been taken at 
the appointed time ; when improper diet has been given instead of 
that directed, when the air in the rooms and many other circum- 
stances have been improperly attended to, whether he has not then 
known the disease to be either aggravated, or diverted from its course, 
often terminating fatally ; when, if no such errors had been commit- 
ted, there was the highest probability of the patient's recovery. 

Air and Temperature. — It being a well known fact that the 
life of every animal depends as much on air as on diet; and its health 
also as much on the goodness of the former, as on that of the latter, 
care should be taken what sort of rooms we sleep in, but more espe- 
cially so when confined by sickness. 

It is a misfortune that the poor as well as the slaves are constrained 
from necessity to sleep in low dwellings, and many of them in the 
same room, by which due attention is not generally paid to cleanli- 
ness; hence the air becomes impure and extremely offensive. Others 
again accustom themselves, sick or well, to the curtains drawn. This 
is equally detrimental to health, for the air being thus confined, be- 
comes contaminated, and so offensive as to be disagreeable to any 
one entering the room from the fresh air. How much more so 
then must this be the case in sickness, which tends greatly to destroy 
its purity. 

In warm weather it is necessary to keep a window open day and 
night, during the whole course of the disease ; but in this case the 
nurse must take care that the patient is not exposed to either a damp 
or violent current of air. Whenever a fire is required, it should be 
kept up, and regulated according to the nature of the disease, and 
state of the weather. The room being brought to a due heat, should 
never be suffered to cool suddenly ; for the air ought to be kept as 
temperate as possible. 

When the general exhaustion is great, the temperature of the 
apartment should not by any means be permitted to be so low as to 
endanger an attack of chilliness; as in this case a rapid reduction of 
the animal heat may speedily be fatal, by sinking the heart's action. 
In some instances an exposure to the cold air, in getting up to the 
night-chair, has been the cause of a shivering fit, under which the 
patient died in a few hours; but death will rarely happen, if some 
Avarrn stimulant be immediately administered internally, and suffi- 
cient warmth applied to the extreme parts of the body. 

Chills and Fevers. — It is too prevailing a custom in the cold 
fit of an ague, or when the patient complains of chilliness, for the 
attendants to heap great loads of bed clothes, which never fail to 
produce difficult or oppressed perspiration. In such cases, warmth 
should be restored by applying warm flannels to the stomach and 
abdomen, and the same or warm bricks to the feet. Recourse 



THE NURSE'S GUIDE. 611 

should also be had to friction with a flesh brush or flannel on the 
extremities. 

It is vulgarly imagined that it is absolutely necessary to promote 
perspiration, and under this absurd idea, heating and stimulating 
drinks are given by way of cordials which readily induce delirium 
or a more obstinate fever. The fact is this, when the pulse is quick 
and the body hot, sweat can only be induced by lessening the action 
of the pulse, and heat of the body. And this can only be accom- 
plished by strict observation of a cooling regimen. 

In some cases, it is necessary, that the sick person should be kept 
out of bed as much as possible; and placed so, as to face the current 
of air ; the body being defended sufficiently by the clothing, to pre- 
vent any inconvenience being experienced. It should be recollected, 
however, as we have already noticed, that in the stage of collapse, or 
when the exhaustion is great, this practice is not admissible. But 
there is much less reason to fear this practice will be too frequently 
adopted, than it will be neglected, in those cases in which it is re- 
commended. For, too often, in this point, are the wishes of the 
physician opposed, and his directions disobeyed ; the languor of the 
patient, and the unwillingness to be removed, with the prejudices 
against a practice so novel, forming, very often, almost insuperable 
obstacles. Indeed, it is very difficult to persuade those, who have 
not witnessed the effects resulting from this mode of practice, that it 
is not necessary, for every person in a fever to be kept closely con- 
lined to his bed under a load of bed-clothes and supplied with heat- 
ing drinks. It frequently happens, therefore, that no sooner has a 
physician left the room, than the patient is supplied with warm li- 
quors, the windows and curtains are closed, and the bed-clothes, 
which had been removed, are replaced. Such opposition to the di- 
rections of a physician, viewed in the most favourable light, is highly 
censurable ; being, in a great measure, the effect of ignorance, it is 
all that prevents it from being really criminal. 

Nurses should, therefore, be on their guard, and neither deviate 
themselves from the rules laid down, nor permit any person at the 
expense of the patient's life to interfere with what might be consi- 
dered their duty, otherwise their conscience will upbraid them as 
murderers. 

It is to be hoped, by means of this treatise, ignorance will no lon- 
ger be a cloak for omissions, and that one uniform method will be 
attained in the management of the sick, which will unquestionably 
be of vast importance to mankind. 

Cleanliness. — It is certainly of great moment to the sick to 
have their bed and bedding kept clean as possible, and their linen 
frequently changed that it may not become foul or offensive. — Such 
of the bed-clothes, as are not changed, should, in diseases of a putrid 
nature, be exposed to a current of air, since, by their known capacity 
for retaining effluvia, they may become so loaded with contagious 



612 the nurse's guide. 

and putrid matter, as to prove infectious to the attendants, and, per- 
haps, to impede the recovery of the patient. 

In summer it is much more healthy to sleep on mattresses than 
feather beds, which are apt to make persons become faint and lan- 
guid. The best materials for making mattresses are, clean horse- 
hair, Carolina moss properly cured, corn husks split, or straw. 

When a bed is unsettled, or a patient's head uncomfortably low, 
or when his feet are pushed from under the bed-clothes, he should 
be raised in bed, and the bed, bolster, and covering shook up and 
smoothed. 

The patient's face and hands are to be washed every morning. 
And when he is no longer able to assist himself, his face, breast, 
hands, and arms, must be frequently sponged with vinegar and wa- 
ter. The floor should be kept clean and occasionally sprinkled with 
vinegar, particularly before it is swept, and on no account should any 
thing the least offensive be suffered to remain in the room. 

It is also the duty of the nurse to pay great attention to the state 
of the patient's mouth. When his tongue and gums are covered 
with a brown or dark crust, she must wipe them with a bit of flannel 
moistened with salt and water, two or three times a-day ; or, if this 
cannot be accomplished, she must put a thin slice of lemon, without 
the rind, in his mouth. The patient is often unable to swallow, 
from the dry and shrivelled state of his tongue; in such cases, the 
nurse, before offering him drink, should put a tea-spoonful of lemon 
juice and water, or vinegar sweetened, into his mouth ; after which, 
the scum upon his tongue will become softened in a minute or two, 
and then he will drink with ease. 

Delirium. — When, during great derangement of mind, a patient 
insists upon leaving his bed, the nurse must endeavour to calm him ; 
or, if that should fail, she may speak with authority, but she is not 
on any account to use forcible restraint. The nurse must wrap his 
legs in a blanket, put on his bed gown or cover his shoulders, and 
permit him to sit on his bed, or even to go to the fire, till the vio- 
lence of his derangement shall abate. When indulged in this way, 
he will, in general, soon return to the bed of his own accord. In 
the putrid fever, delirium is one of the most constant and alarming 
symptoms, and the removal of it depends much upon the nurse or 
attendants. We have seen a temporary stop put to the patient's 
raving, by making him drink, or upon his discharging his urine or 
faeces : for being then unconscious of thirst and other natural wants, 
he is, therefore, ignorant of the means of satisfying them : and when 
he does so, he fancies he is about something else, which is the sub- 
ject of his delirious thoughts. This observation leads to a material 
practical purpose ; for it follows from it, that unremitting attention 
should be given to the patient's feelings, and all his possible wants, 
as those natural notices, and instinctive cravings, which occur in 



the nurse's guide. 613 

health, are now wanting, in consequence of the depraved state of 
sensation. 

The following excellent passage will be found in Levant's Chap- 
ter on the Synochus Putris (Nervous Fever.) As soon as the deli- 
rium comes on, the pain subsides, or at least the patient does not 
complain of pain, nor seem to feel any; but replies in a hurried 
manner, when asked how he does, that he is very well ; according to 
the observation of a French physician " Q,uand ie malade repond, je 
me porte bien, ce seui mot suffit, il n'est pas plus a' lui." " When 
the patient answers that he is very well, this alone convinces me," 
says Dr. Cheyne of Dublih, " that he is no longer himself. In all 
these cases, the patient endeavours to get out of bed, to sit up, or 
even to walk about from one room to another ; but, unhappily, the 
attendants are solicitous to confine him to bed, and to load him with 
bed-clothes; nay, he is frequently kept struggling for two or three 
days together, with two strong people lying upon him continually. 
Now, to prevent all this misery, I know no method equal to what is 
here recommended; namely, let the patient have his clothes put on, 
and be placed in an easy chair; let his head be shaven, washed with 
vinegar, and covered with a linen cap. When he is tired of the 
erect posture, let him lie along on a couch, or upon the bed, with his 
head high. Let his diet be cooling, and his body be kept open by 
clysters, repeated occasionally. Let this method be persisted in till 
his delirium goes ofT; or till the pulse subsides, and he seems ex- 
hausted ; then, perhaps, he will begin to doze, or slumber on his 
chair, which will do him no harm, and when he is inclined to go 
into bed, let him lie down. By this method," adds Dr. C, " I have 
recovered great numbers of persons, when I was suffered to conduct 
them in the hospital; and I do believe some have perished by an op- 
posite treatment, who "might have been saved." 

Medicine. — Although it be admitted, the cure of diseases de- 
pends very much upon the right choice of medicines ; yet, it cannot 
reasonably be expected that these will produce the desired effect un- 
less they be punctually taken, agreeably to the directions given. 

It has oftentimes occurred, that when aperient powders containing 
calomel have been prescribed, and directions given that they should 
be administered in syrup or molasses, the physician, on making the 
necessary inquiry on the following day, has been told by the nurse 
that they had no effect upon the bowels. " How was the medicine 
given?" "In tea, sir." " Why was it not administered agreeably 
to instructions?" " Because the patient preferred taking it in a 
liquid, and I thought it would answer as well." By thus changing 
the vehicle, the calomel being heavier than the tea, was left at the 
bottom of the spoon, and, as it was not swallowed, could not, of 
course, have any purgative effect. In like manner, the patient or 
nurse frequently thwarts the intention of the physician by making 
use of the medicines prescribed, irregularly ; so that if there be any 



614 

particular action to be kept up on the system, it is rendered abortive, 
'and blame cast where it should not rest. It is not unusual for medi- 
cines, though ever so well adapted to the case, to excite nausea and 
retchings immediately after each dose has been taken. Hence, a 
prejudice arises directly against the medicine, which being taken for 
the cause, it is condemned and set aside. The consequence is, the 
disease becomes more aggravated. Cases may happen, wherein if 
but one medicine be neglected, it can never be administered again 
properly; and, consequently, the patient may either be lost, or greatly 
injured. It is, therefore, the duty of the nurse, when a physician 
prescribes in whom confidence can be placed, strictly to adhere to 
the curative process he selects, as without such attention iEsculapius 
himself might fail. 

It commonly occurs, through the course of many diseases, particu- 
larly fevers, that the patient has little or no inclination to eat, till na- 
ture has gained the victory. But this not being rightly understood 
by either him or his attendants, an outcry is made that he will never 
have an appetite whilst he takes medicine. Hence the remedies are 
discontinued ; yet the appetite does not recover, nor does the case 
grow better, but rather worse. The reason is obvious, if they would 
but only observe, that as the disease is cured, the appetite in conse- 
quence will revive. 

Again, it not unfrequently happens in diseases which are obsti- 
nate, requiring a long course of medicines, that the patient becomes 
impatient and discontinues the use of the remedies. And in such 
cases, it is too common, that the patient becomes prejudiced against 
his physician and mistrusts his ability wholly, though perhaps he 
has been conducted by him through the most difficult stages of his 
illness, and not uncommonly sends for another, who, if not so 
honest as to undeceive him, enjoys the honour that was due to the 
former. 

By these observations we do not mean to screen any unskilful or 
improper use that maybe made of medicine, or to raise it into higher 
esteem than what it deserves ; on the contrary, it will ever be found 
I hat he who knows his business best, will make his constant care to 
heal with fewest medicines ; and will always be most ready to re- 
sign his patient to diet alone , as soon as he knows it can be done 
with safety. 

During a long spell of sickness it not unfrequently occurs, that 
good-natured friends are in the habit of recommending nostrums, 
each on the supposition that his own is infallible. When the pa- 
tients are credulous, as is too often the case in lingering diseases, 
they readily grasp at any relief, however monstrous the proposition 
may appear : the consequence is, that in nineteen cases out of twenty, 
the medicaments of which they are composed are utterly unfit for 
the disease, and, consequently, prove deleterious in their effects. 

It too frequently occurs that insuperable difficulties of another 
kind arise. For a there are some persons bred up with strong preju- 



the nurse's guide. 615 

dices, and an excessive like or dislike of certain things, and cannot 
easily be persuaded to comply with what is thought the most proper 
method of cure ; namely, a particular regimen, bleeding, vomiting, 
&c. And thus their lives are often lost, or if they survive, the fu- 
ture period of their existence is rendered very miserable by some 
consequent disease remaining fixed in the constitution. Again, we 
often find, with respect to children who have been much indulged, 
when the physician ascertains the nature of the disease, and pre- 
scribes suitably to the case, he will very likely be told by the parents, 
if he expect any medicine to be gotten down, it must either be nicely 
flavoured, or absolutely without taste. Or, should he advise topical 
bleeding by leeches, he will more than probably be told, however 
necessary their application may be, it is a remedy which must be de- 
clined, for the very sight of them would throw the child into convul- 
sions. — And, as to a blister, the infliction of this torture on such deli- 
cate skin could not be endured ; for as soon as any pain from its ac- 
tion was produced, it would be directly torn off. Placed under such 
limitations, it cannot be expected, however capable and anxious the 
physician may be to procure relief to his patient, that much advan- 
tage can be obtained from his prescriptions. He, therefore, either 
declines his attendance, or acting within the bounds to which he is 
limited, he does little more than alleviate some of the more distress- 
ing symptoms, whilst he has the mortification to witness the almost 
uninterrupted progress of the disease. 

Leeches. — As these little animals are depended on for the remo- 
val of very dangerous diseases, and as they often seem capriciously 
determined to resist the endeavours made to cause them to adhere, 
it will be proper to give a few directions, by which their assistance 
may, with more certainty, be obtained. 

This useful ally to the physician, it may be remarked, is as little 
fond of the taste of physic as the physician can be himself. The 
introducing of a hand, to which any ill-flavoured medicine, adheres, 
into the water they are kept, will be often sufficient to deprive them 
of life ; the application of a small quantity of any saline matter to 
iheir skin, immediately occasions the expulsion of the contents of 
their stomach ; and, what is most to our present purpose, the least 
medicament that has been applied, remaining on the skin, or even 
the accumulation of the matter of perspiration, will prevent them 
from fastening. The skin should, therefore, previously to their ap- 
plication, be very carefully cleansed from any foulness, and mois- 
tened with a little milk. 

The best mode of applying them is by retaining them to the skin 
in a small wine-glass, or the bottom of a large pill box, when they 
will, in general, in a little time, fasten themselves to the skin. On 
their removal, the rejection of the blood they have drawn mav be 
obtained by the application of salt externally; but bore, for the sake 
of those to whom we are so much indebted, it may be necessary to 



616 the nurse's guide. 

remark, that a few grains of salt are sufficient for this purpose ; and 
that covering them with it, as is sometimes done by nurses, generally 
destroys them. It sometimes happens, that the blood will continue 
to flow from the orifice made by a leech longer than is desirable ; 
and, sometimes, children have been nearly lost from the inability 
of the attendants to suppress the discharge. In such cases, the 
blood should be washed off clean, and the point of the finger pressed 
moderately hard on the orifice, when the blood will cease to flow. 
A small compress may then be applied to the wound, w^hich may 
be retained by the point of the finger as long as the blood appears 
upon withdrawing the pressure ; remembering that no more blood 
need be suffered to flow, than is thought necessary ; since all that 
is required to prevent it, is patiently to persevere in the necessary 
pressure. 

It sometimes occurs, on the application of leeches to the funda- 
ment, in order to relieve the piles, that they get into the rectum. If 
that accident should happen, an injection of a solution of common 
salt is the proper remedy ; but the animal is soon gorged, and then 
may be destroyed. 

Clysters. — As the use of clysters is also of great importance in 
the cure of many diseases, and as nurses are not always conversant, 
even in this part of their office, it may be proper to give some direc- 
tions relative to the administration of them, which may be done in 
the following manner : The bed being prepared with a sufficiency 
of clothing to keep it dry, the patient must be placed on the side 
across it, with the knees forward, and then covered decently ; the 
clyster being likewise prepared, and brought to that moderate heat 
called milk warm, must be poured into the bladder and secured by 
tying the opening; which being done and the pipe anointed, the 
whole must be placed in the bed near to the patient. The nurse 
must now pass the point of her left forefinger, the nail being cut 
short, close to the anus, or a little within it, and then slide the pipe 
along this finger, till the greatest part of it be entirely introduced. 
In doing this, the pipe must be directed a little backwards, taking 
care not to push it against any part so as to cause pain. When thus 
introduced, its outer end must be held fast with one hand, whilst 
with the other she takes hold of the string, and pulls out the cork -, 
which done, the bladder must be grasped with both hands, and the 
contents forced up, keeping the pipe in its place at the same time. 
When the clyster has been pressed out of the bladder, the pipe must 
be instantly withdrawn. 

A large pewter syringe is more convenient to administer an injec- 
tion ; and some of them are so constructed that the patient may use 
it himself. 

Diet. — In the cure of diseases, experience proves how much de- 
pends upon the choice and administration of diet. We see one 



the nurse's guide. 61 7 

series of disorders, wherein the appetite, either from a bad habit or 
some morbid effect, craves such thing's chiefly as have a tendency to 
heighten the disease. Another series, in which the whole fabric- 
being fully engaged and struggling with the disease in order to con- 
quer it, the stomach, till in that conflict nature gets the better, loathes 
every kind of aliment, except such as is fluid. And we see in the 
third class, the stomach not affected, but dispensing with all kinds 
of food. Yet these being taken indiscriminately, the disease is not 
only nursed, but the medicines usually the most efficacious in curing 
it, are rendered entirely ineffectual. 

The nurse should, therefore, be extremely cautious how she devi- 
ates from the diet which has been prescribed, as fatal consequences 
may arise from what may seem to have been but a trifling variation. 

The stomach must never be oppressed with much at a time, about 
half a pint being enough, and that should be repeated only as nature 
indicates. This will, generally, be known by the patient's desire or 
dislike of it. We say generally, for in some cases where there is 
great weakness, insensibility, or both, the patient may not be able to 
give such indication. And there are cases, especially fever that ter- 
minates badly, where the patient's thirst is insatiable. In either of 
these exigencies, the nurse must proceed with discretion ; that is, in 
the former she must rouse the patient every hour or two, and give a 
cupful or half a pint of such drink as directed ; and, in the latter, 
she must give drink more frequently, but small quantities at a time. 
But it should be observed that, whenever patients fall into tranquil 
slumber, they should hardly ever be disturbed to give them drink or 
food until five or six hours shall have elapsed. Such a repose is 
most desirable, and will, sometimes, renovate nature, when her fa- 
culties had before seemed prostrate, beyond the power of recovery. 

It is a vulgar error, and a very common one too, that a sick person 
is to be supported by rich broths, by pastry, or by solids. The out- 
cry is, that the doctor will starve him. 

Hence a variety of dishes is prepared to tempt the stomach to take 
food, and, in order to provoke the appetite, pickles are frequently 
given. The patient, from the extreme kindness of friends or offi- 
ciousness of the nurse, is teazed with repeated urging, to try to take 
a little more, until the stomach has received so much as to produce 
effects directly opposite to those intended. Even after the disease is 
conquered, and the appetite begins to crave, it is always advisable to 
feed the patient sparingly for several days. Unlimited indulgence in 
the article of food, is a source from which a multitude of diseases 
arises in health ; then how much more deleterious in its effects, must 
this be the case in a state of convalescence. 

At this crisis, it is, indeed, a nice point to avoid giving the patient 
too much or too little nutriment ; but even here, perhaps, excess is 
the most dangerous extreme. Great anxiety to prevent the sick from 
sinking, often induces their attendants and friends to give much more 
food than can possibly be digested, and it often lies as an offensive 
78 



618 

load upon the stomach, or induces an exhausting vomiting or diarr- 
hoea. When the weakened condition of the digestion or assimilative 
organs are considered, it cannot but appear, even from that reason, 
that small portions of plain, simple food, given at stated intervals, will 
best support the remaining strength of the system, and this is really 
confirmed by experience. 

In preparing all kinds of aliment, it is essentially necessary to be 
very cleanly, but more especially in that for sick people, the stomach 
being often so greatly weakened and disordered by the disease, as to 
render it difficult to find out by way of diet, what is agreeable to the 
natural powers, and suitable to the case. 

The nurse, who ought to be the cook, with respect to this part of 
diet, may select, from the articles enumerated for the sick, such ali- 
ments as are suitable to the case. It is advisable that a choice be 
made of the things most likely to agree with the patient, that a 
change be provided, as invalids require variety; and that they should 
succeed each other in different forms. 

Conclusion. — I believe I have now completed the task that was 
allotted me, and sincerely hope, notwithstanding its imperfections, 
the improvements I have made to the seventh edition of the "Medi- 
cal Companion," will greatly enhance its value, and be productive 
of much comfort and good. So long as sickness is a concomitant 
of humanity, so long will a work of this kind retain its estimation. 
By persons in health, the possession of such a book may not be suf- 
ficientty prized; but when sickness finds access to a beloved wife or 
child, it will doubtless be read with pleasure, and considered in reality 
a valuable and acceptable companion for the sick chamber. 

It is not to one description of persons alone that the " Medical 
Companion," will prove useful, but to every class of society. — Many 
families are ignorant even of the mode to prepare the various articles 
of diet suitable for the sick, and, with such, this part of the work, as 
a Family Assistant, must be of incalculable value. To the in- 
quisitive mind, the attentive perusal of this book, from the begin- 
ning to the end, will be found to contain so many interesting facts, 
as will not fail to prove a source of rational and instructive enter- 
tainment. 

To diffuse medical knowledge, is the most effectual mode of 
checking the career of empiricism ; and, indeed, so obvious is this, 
that it is surprising to find heads of families pay so little attention to 
the perusal of books of this kind, wherein they might obtain such in- 
formation as would enable them to detect ignorant pretenders in the 
healing art, as well as afford them the very great satisfaction of ren- 
dering that assistance in the management of the sick, for which hu- 
manity often loudly calls.— Such knowledge is also highly useful, 
on the one hand, in preventing unnecessary apprehension respecting 
symptoms by no means dangerous ; and, on the other, in giving the 
alarm, where delay might be injurious or fatal. And, again, there 



DIET FOR THE SICK. 619 

are situations in which a little medical knowledge may be of essen- 
tial consequence to the comfort, or even the life of the patient, before 
regular assistance could be procured. 



DIET FOR THE SICK. 

Sage Tea. — Take of the leaves of green sage, plucked from the 
stalks and washed clean, half an ounce, (a handful,) loaf sugar an 
ounce, outer rind of lemon peel, undried, a quarter of an ounce, or 
a little lemon or lime juice, boiling water, two pints. Infuse them 
in a mug or pitcher, covered, for half an hour, and then pour ofT the 
tea. When the sage is dried, it must be used in a less proportion 
than that above. 

In the same manner teas may be made of balm, ground ivy, cat- 
mint, rosemary, southern wood, &c. The lemon peel, or lemon 
juice, being omitted or not, and the sugar lessened or increased, as 
occasion requires. 

Lemons, or apples cut in slices, tamarinds, currants, fresh or in 
jelly, cranberries, dried whortleberries infused in boiling water, 
sweetened with sugar or syrup : these may be so prepared and varied 
in form, as to suit every taste, and to answer the purpose of pleasant, 
cooling, and salutary drinks, in all febrile complaints. Such drinks 
should always be kept in a covered vessel. 

Bran Tea. — Take of bran, fresh ground, two hands full ; mo- 
lasses or honey one spoonful ; boiling water, six pints. Mix them 
well, and when they have stood covered about three or four hours, 
strain off the tea. 

' Flax-seed Tea. — Take of flax-seed, one ounce ; white sugar, 
one ounce and a half; lemon juice, two table-spoons full ; boiling 
water, two pints. Infuse them in a pitcher some hours, and then 
strain off the liquor. An ounce of liquorice shaved, may sometimes 
be used instead of sugar. 

Camomile Tea. — Take of camomile flowers, one handful ; boil- 
ing water, one gallon. When they have stood covered about half 
an hour, strain off the tea. If the drinking this tea be to strengthen 
the stomach, it must be made stronger, as for instance, about a quar- 
ter of an ounce to a pint. 

Lemonade. — Take of the outer rind of fresh lemon peel, about 
one drachm; lemon juice, one ounce; double refined sugar, two 



620 DIET FOR THE SICK. 

ounces ; boiling water, a pint and a half. When they have stood 
in a vessel about ten minutes, strain off the liquor. 

Orangeade. — Take of the fresh outer rind of Seville orange, one 
drachm ; orange juice, two or three table-spoons full ; white sugar, 
one or two ounces, or enough to make it of an agreeable sweetness ; 
boiling water, one quart. When they have stood in a pitcher about 
ten minutes, strain off the liquor. 

Imperial Drink. — Take of cream of tartar, one drachm ; the 
outer rind of fresh lemon or orange peel, half a drachm ; loaf sugar, 
one ounce ; boiling water, two pints. When they have stood in a 
pitcher about ten minutes, strain off the liquor. 

Barley Water. — Take a handful of either pearl barley, or the 
common sort, wash it clean, first in cold, and afterwards in boiling 
water, then simmer it in a quart of water for an hour ; when half 
done, put into it a bit of fresh lemon peel and a little sugar. — Rice 
water may be prepared as above. 

Toast Water. — Toast slowly a thin piece of white bread till 
extremety brown and hard, but not the least black, then plunge it 
into a jug of cold water, and cover it over an hour before used. 

Pectoral Drink. — Take of common barley and raisins stoned, 
each two ounces ; liquorice root, half an ounce; water, two quarts. 
Boil the water first with the barley, then add the raisins, and after- 
wards, near the latter end of the boiling, the liquorice. The decoc- 
tion then will be fully completed, when one quart only of the liquor 
will be left after straining. 

Arrow-root Jelly. — Mix a large spoonful of the powder with 
a tea-cupful of cold water, by degrees, then pour this into a pint of 
boiling water, stirring it well, and when it boils it is finished. A 
little sugar and nutmeg may be added. Or prepare it as directed 
under the head of Arrow-root. — (See Materia Meclica.) 

Sago Jelly. — Take of sago, washed well, one large spoonful ; 
water, nearly a pint. Boil them gently, stirring often, till the mix 
ture is smooth and thick; then add two spoons full of wine, a little 
nutmeg, and sweeten it to the taste. A bit of lemon peel added to 
it when boiling, gives it a pleasant taste and flavour, and with some 
patients it agrees better when boiled in milk. 

Tapioca Jelly. — Choose the largest sort, pour cold water on to 
wash it two or three times, then soak it in fresh water five or six 
hours, and simmer it in the same until it becomes quite clear, then 



DIET FOR THE SICK. 621 

put lemon juice, wine, and sugar. The peel should be boiled in it. 
It thickens very much. 

Calves' Feet Jelly. — Boil two calves' feet in one gallon of 
water till it comes to a quart, then strain it, and when it is cold, skim 
the fat entirely off, and take the jelly up clean ; if there be any set- 
tling at the bottom, leave it. Put the jelly into a saucepan, with a 
pint of mountain wine, half a pound of loaf sugar, the juice of four 
large lemons, and the white of six or eight eggs, beat up the whisk ; 
mix all well together, set the saucepan upon a clear fire, and stir the 
jelly till it boils. When it has boiled a few minutes, pour it through 
a flannel bag till it runs clear. — Have now ready a large china basin, 
with some lemon peel in it, cut as thin as possible, let the clear jelly 
run upon them while warm, and from these it will acquire both an 
amber colour, and an agreeable flavour. Afterwards it may be 
poured into glasses. 

Boiled Flour. — Take a pound or two of fine flour, tie it up as 
light as possible in a linen rag, dip it repeatedly in cold water, and 
dredge the outside with flour till a crust is formed around it, which 
will prevent the water soaking into it while boiling. It is then to 
be boiled till it becomes a hard dry mass. Two or three table- 
spoons full of this may be grated down and boiled in milk and water 
to a proper thickness, and sweetened to the patient's taste, and a 
little nutmeg or other spice may be added. This forms an excellent 
food in dysentery, and in bowel complaints in children. 

Water Gruel. — Take of the coarse part of com meal or grist, 
two hands full; water, three quarts; boil it till only two quarts re- 
main, then strain off the liquor, and season it to the palate with salt, 
sugar and nutmeg, to whicli may be added a spoonful or two of 
wine. 

Or, take of oatmeal, two large spoons full; water, one quart ; mix 
them well, and boil them about ten or fifteen minutes, stirring often; 
then strain the gruel through a sieve, and add sugar and salt enough 
to make it agreeable to the taste. When it is designed as a meal, 
dissolve it in a little butter, and then add bread and nutmeg, as oc- 
casion requires. 

Rice Milk. — Take a large tea-cupful of rice, washed nicely ; 
water, one pint; boil it for about half an hour, then add a quart of 
new milk; let it simmer over a slow fire till it is sufficiently done, 
and then add to it a little susrar and nutmeg. 



*&' 



Treacle Posset. — Take of milk one pint, put it on the coals 
till it just begins to boil, then add two or three table-spoons full or 
iicacle or molasses, stirring the milk as it is poured in. When mixed 
: t is lit for use. 



622 DIET FOR THE SICK. 

Panado. — Take of bread one ounce ; mace, one blade ; water, 
one pint — Boil them without stirring, till they mix and turn smooth, 
then add a little grated nutmeg; a small piece of butter, and sugar 
enough to make the mixture agreeable. When butter is not ap- 
proved of, two spoons full of wine may be used in its stead. 

Or, set a little water on the fire, with a glass of white wine, some 
sugar, and a scrape of nutmeg and lemon peel ; mean while, grate 
some crumbs of bread. The moment the mixture boils up, keeping 
it still on the fire, put the crumbs in, and let it boil as fast as it can. 
When of a proper thickness just to drink, take it off. 

White Caudle. — Take of oatmeal two table-spoonsful ; water, 
one quart ; mace, two or three blades ; three or four cloves. Mix 
them well together, boil them about fifteen minutes, stirring often, 
then add a few slices of the outer rind of a lemon ; when the mix- 
ture has boiled about fifteen minutes, strain it through a sieve. As 
it is used, add to it white wine, grated nutmeg, white sugar enough 
to make it agreeable to the patient. Toasted bread is to be added 
likewise, as the appetite may require. 

Or, put into a pint of fine gruel, made of coarse corn meal, or 
grits, while it is boiling hot, the yolk of an egg beaten with sugar, 
and mixed with a large spoonful of cold water, a glass of wine, and 
nutmeg. Mix by degrees. Some like gruel, with a glass of table 
beer, sugar, &c, with or without a tea-spoonful of brandy. 

Flour Caudle. — Into five large spoonsful of the purest water, 
rub smooth one dessert spoonful of fine flour. Set over the fire five 
spoonsful of new milk, and put two bits of sugar into it ; the moment 
it boils, pour into it the flour and water, and stir it under a slow fire 
twenty minutes. It is a nourishing and gently astringent food. 

Rice Caudle. — When the water boils, pour into it some grated 
rice, mixed with a little cold water; when of a proper consistence, 
add sugar, lemon peel, and cinnamon, and a glass of brandy to a 
quart. Boil all smooth. 

Bread Soup. — Take the upper crust of a roll, the drier the bet- 
ter ; or two or three crackers, cut or break them into pieces, and put 
it into a saucepan, with a pint of water, and a piece of butter about 
half as big as a walnut; boil them well, every now and then stirring 
and beating them, till the bread is mixed ; then season the soup with 
a very little salt, and pour it into a basin. 

Egg Soup. — Take of water one pint; the yolk of an egg; butter 
the bigness of a small walnut; sugar enough to make it agreeably 
sweet. Beat up the yolk with the water, and then add the butter 
and sugar. Stir it all the time it is upon the fire; when it begins to 



DIET FOR THE SICK. 623 

boil, pour it to and fro between the saucepan and mug till it be 
smooth and well frothed, and then it will be fit to drink. 

Beef Tea. — Cut one pound of lean beef into thin slices or shreds, 
and boil it in a quart of water for twenty minutes, taking off the 
scum as it rises. After it grows cold, the liquor should be strained, 
in which state it resembles a light infusion of green tea, has a very 
grateful flavour, and is more strengthening than other broths. 

Chicken Broth. — Take a middling-sized chicken, divide it into 
two parts, put one half into a saucepan, with a quart of water, sea- 
soned with a little salt; as the scum rises take it off; then may be 
added a small. bundle of parsley, and a crust of bread; when they 
have boiled about three-quarters of an hour, the parsley may be ta- 
ken out, and the broth will be fit for use, or it may be used seasoned 
only with salt. 

Mutton Broth. — Take of mutton one pound ; water three pints. 
Put them into a saucepan, and set it upon a clear fire, throw in a 
little salt, and as the scum rises take it carefully off with a spoon ; 
then add a small onion, if there be no objection to it, and a little 
parsley. Boil till the meat is very tender, then take it out, pour the 
broth into a basin, and when cold, skim the fat part which is con- 
gealed on the surface, entirely off; after which, a part of the broth 
may be warmed and given to the patient as often as needful. A 
little boiled rice or barley may be added here occasionally. 

Calves' Feet Broth. — Boil two feet in three quarts of water, 
to half, strain and set it by; when to be used, take off the fat, put a 
large tea-cupful of the jelly into a saucepan, with half a glass of 
sweet wine, a little sugar and nutmeg, and beat it up till it be ready 
to boil, then take a little of it, and beat by degrees to the yolk of an 
egg, adding a bit of butter, the size of a nutmeg, stir all together, but 
do not let it boil. Grate a bit of fresh lemon peel into it. 

Boiled Pigeon. — Take one pigeon, drawn and washed very 
clean ; boil it in a sufficient quantity of milk and water; that is, about 
half a pint of each, for fifteen minutes. When thus prepared, it may 
be taken out and eaten with the following sauce : — Take the liver 
parboiled, bruise it fine, with a little parsley boiled, and finely chop- 
ped ; melt some butter, and mix a little of it first with the liver and 
parsley, and then add the rest, and pour the whole upon the pigeon. 

To broil Pigeons. — After cleaning, split the backs, pepper and 
salt them, and broil them very nicely; baste with butter, and serve 
as hot as possible. 



624 DIET FOR THE SICK. 

Roasted Pigeons — Should be stuffed with parsley, either cut or 
whole, and seasoned within. Serve with parsley and butter. 
Partridges and other birds may be dressed as above. 

Bread Pudding. — Take of crumbs of bread about half a pound ; 
new milk, about three-quarters of a pint. Pour the milk boiling 
hot upon the bread, and let it stand about an hour covered close up ; 
then add the yolks of two eggs, well beaten; a little grated nutmeg; 
about a spoonful of rose water ; a little salt, and sugar also if agree- 
able ; beat the bread well, and mix the whole together with a spoon. 
Tie it then close up in a clean linen cloth, and when the water boils, 
put it in ; boil about three-quarters of an hour, then take it out, lay 
it upon a plate, pour over it some melted butter mixed with a little 
mountain wine, if there be no objection, and sprinkle a little sugar 
over all. 

Batter Pudding. — Rub three spoonsful of fine flour extremely 
smooth, by degrees, into a pint of milk ; simmer till it thickens, stir 
into it two ounces of butter, set it to cool, then add the yolks of 
three eggs ; flour a cloth that has been wet, or butter a basin, and 
put the batter into it ; tie it tight, and plunge it into boiling water, 
the bottom upwards. Boil it an hour and a half, and serve with 
sweet sauce. If approved, a little ginger, nutmeg, and lemon peel, 
may be added. 

Rice Pudding. — Wash and pick some rice, throw among it some 
pimento finely pounded, but not much ; tie the rice in a cloth, and 
leave room for it to swell. Boil it in a quantity of water for an hour 
or two. When done, eat it with butter and sugar, or milk. Put 
lemon peel if you please. It is very good without spice, and eaten 
with salt and butter. 

Or, swell the rice with a very little milk over the fire, then add 
some more milk, an egg, sugar, allspice, and lemon peel. Bake in 
a deep dish. 

Potato Pudding. — Take eight ounces of boiled potatoes, two 
ounces of butter, the yolks and whites of two eggs, a half pint of 
new milk, one spoonful of white wine, a morsel of salt, the juice 
and rind of a lemon beat all to froth ; sugar to taste. — A crust or not, 
as you like. Bake it. 

Custard Pudding. — Mix by degrees a pint of good milk with a 
large spoonful of flour, the yolks of four eggs, and a little pounded 
cinnamon. Butter a basin that will exactly hold it, pour the batter 
in, and tie a floured cloth over. Put in boiling water over the fire, 
and turn it about a few minutes, to prevent the egg going to one side. 
Half an hour will boil it. 



DIET FOR THE SICK. 625 

Wine Whey. — Take of new milk two pints ; water one pint ; 
white wine one gill. Put the milk and water into a saucepan, well 
tinned, and set them upon a clear fire, and when they begin to boil, 
throw in the wine. Boil them about fifteen minutes, during which 
time, as the curd, or cheesy part collects, take it off with a spoon, 
and if the whey be not clarified enough with this quantity of wine, 
add a spoonful or two more ; then boil it a little longer and skim it, 
by which means it will become sufficiently fine, and then it may be 
poured into a basin for use. 

Or, put half a pint of new milk on the fire ; the moment it boils 
up, pour in as much sound raisin wine as will completely turn it, 
and it looks clear; let it boil up, then set the saucepan aside till the 
curd subsides, and do not stir it. Pour the whey off, and add to it 
half a pint of boiling water, and a bit of white sugar. Thus you 
will have whey perfectly cleared of milky particles, and as weak as 
you choose to make it. 

Mustard Whey. — Boil one ounce and a half of mustard in 
powder, in a pint of milk, and an equal portion of water, till the 
curd be entirely separated, after which the liquid is strained through 
a cloth. This preparation is one of the most pleasant and effica- 
cious forms in which mustard can be given. A tea-cupful sweetened 
with sugar, taken three or four times in a day, is exceedingly bene- 
ficial in low fevers as a diaphoretic cordial. Vinegar and lemon 
whey may be formed in the same manner as wine whey. 

Alum Whey. — Boil two drachms of powdered alum in a pint of 
milk till it be curdled ; then strain out the whey. This astringent 
preparation is often employed with advantage in uterine hemorrhage, 
and in diabetes. The dose is two or three ounces, or as much as 
the stomach will bear, several times in the day. 

To mull Port Wine. — Boil some spice in a little water till the 
flavour be gained, then add an equal quantity of wine, some sugar 
and nutmeg; boil it together, and serve with toast. 

Another way. Boil some allspice, or a bit of cinnamon, and some 
grated nutmeg a few minutes, in half a pint of water; then pour 
to it a pint of wine, add sugar to your taste, beat it up, and it will 
be ready. 

To mull White Wine. — Boil a pint of good wine with a table- 
spoonful of allspice ; beat up the yolk of an egg with a little sugar, 
and add it to the wine while boiling. 

Refreshing Drinks in Fevers. — Boil two quarts of water 
with two ounces of tamarinds, an equal quantity of currants and 
raisins, till near a fourth be consumed. Strain it on a piece of 
79 



626 DIET FOR THE SICK. 

lemon peel, which remove in an hour, as it gives a bitter taste if 
left long. 

Tamarinds, currants, fresh or in jelly, or scalded currants, or cran- 
berries, with cold water, make excellent drinks ; a little sugar may 
be added, if agreeable. 

Lemon Water. — Put two slices of lemon, thinly pared, into a 
tea-pot, a small piece of the peel and some white sugar, pour in a 
pint of boiling water, and stop it close two hours. 

Apple Water. — Cut two large apples in slices, and pour a quart 
of boiling water on them, or on roasted apples, strain in two or three 
hours, and sweeten lightly. 



DISPENSATORY 



Having finished, as far as the limits of this work will permit, a 
general detail of the practice of domestic medicine, adapted to the 
climate of our country, it now only remains to notice the medicines 
requisite for family use, and to point out the best forms of prescribing 
them, in the treatment of the different diseases, described in the pre- 
ceding parts of this work. 

The following tables of medicines will be found sufficient to 
answer every purpose of practice, and the expense will be found 
nothing, compared to the great advantages which must result from 
being constantly supplied with them. To render the work still more 
complete, I have, in these tables, annexed to the medicines, their 
doses, according to the age of the patient ; observing, however, that 
whatever general rule may be given, it can only be applied with 
reference to the habit and state of the patient. The judgment of the 
person who administers the medicine must, therefore, be exercised 
in this respect. It will be found that the constitution is often at- 
tended with certain peculiarities, both in relation to medicine in 
general, and also to certain substances, particularly, which knowledge 
is only to be obtained by experience. 



EXPLANATION OF WEIGHTS AND MEASURES. 



20 grains make 1 scruple, 

3 scruples 1 drachm, 

8 drachms • . I ounce, 

1 2 ounces 1 pound. 

A tea-spoonful is equal to 60 drops, or . . 1 drachm. 

A table-spoonful is the measure of ... |- an ounce. 

A large wine-glassful is equal to ... 2 ounces. 



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XII 


> 



DISPENSATORY. 635 



EMETICS, 



Are medicines which excite vomiting, and are usually employed 
in fevers of almost every species, especially when accompanied in 
the commencement with nausea, vomiting, and other symptoms indi- 
cating a disordered state of the stomach. They cleanse the stomach 
of its noxious contents, and prepare the way for the reception of 
other remedies. 

As a general rule, emetics should always be given on an empty 
stomach, and in the morning. They act with greater certainty, and 
with less distress to the patient. They will, however, answer very 
well in the evening. In ordinary cases, administer the medicine in 
divided quantities, so as to guard against too violent an effect, and 
encourage its operation by drinking freely of warm water. 

To check inordinary vomiting from too large a dose of emetic 
medicince, give laudanum, combined with some cordial, apply fo- 
mentations to the pit of the stomach, and sinapisms to the extremi- 
ties. Chicken water, copiously drunk, is sometimes useful by turning 
the action downwards. When these fail, anodyne injections may 
be resorted to, and a large blister should be put on over the region 
of the stomach. 

Of the emetics, the mildest are ipecacuanha, the antimonial solu- 
tion, and antimonial wine, in broken doses. The most active and 
expeditious, are the white and blue vitriol. Where poisons have 
been swallowed, one or other of these should be given in very large 
doses, and repeated every fifteen minutes until the desired effect be 
obtained. — (See Thorn Apple, and Poisons.) 

Antimonial Solution. — Take of tartar emetic, six grains, water 
half a pint; spirits of lavender thirty drops; sugar, one lump. — Mix. 
Dose for adults a wine-glassful every fifteen minutes, which should 
be encouraged by drinking freely of warm water, and afterwards 
turned downwards by taking a bowl of thin gruel made very salt. 



CATHARTICS, 

Are medicines which, by quickening the peristaltic motion, in- 
crease the evacuations of the intestines, or as may happen, induce 
purging. Cathartics differ very materially in their degree of activity ; 
some operating mildly, while others are more violent in their effects. 
The former is usually distinguished by the title of laxatives, and 
the latter by that of purgatives, the harshest of which, are called 
drastic purgatives. 

The primary and most obvious effect of cathartics, is the evacua- 
tion of the bowels. These are liable to various accumulations of a 



636 DISPENSATORY. 

morbid nature, which, remaining, disturb health, and frequently ex- 
cite or confirm disease. Cathartics, in relieving the bowels, under 
such circumstances, extend also their operation upwards, and bring 
down, in many instances, the contents of the stomach. To this 
may be added, that the strong impression which they impart to the 
liver and pancreas, excites these glands to invigorated efforts, and the 
result is a vast increase of their respective secretions. It is in this 
way, that congestions are removed, biliary calculi dislodged, and 
jaundice and other affections, from organic obstruction, cured. They 
also subdue the pulse, equalize excitement, and render important 
service in the management of the febrile and inflammatory cases. 
Exhibited in the commencement of almost any febrile affection, they 
will often arrest its progress, and, during the subsequent or more ad- 
vanced periods, they are sometimes daily repeated, and, so far from 
weakening, add to the strength of the patient. 

As in the case of emetics, give the medicine on an empty stomach, 
and either in the morning or at bed-time. By doing this, we prevent 
its being rejected, and secure a much more easy and effectual opera- 
tion. And it should be recollected, as cathartics are of very different 
properties and modes of operation, they should carefully be selected 
according to the circumstances of the case. 

Laxatives. — Of this description are castor oil, sweet oil, magnesia, 
calomel, neutral salts, sulphur, cream of tartar; as also the cathartic 
mixture, and the aperient and diaphoretic pills, in broken doses. 

Cathartic Mixture. — Take of Glauber salts, one ounce and a half; 
lemon juice or sharp vinegar, one ounce; water, half a pint; sugar, 
a sufficient quantity to sweeten it. — Mix. 

Or, take of cream of tartar finely powdered, and manna, each one 

ounce; water, half a pint; sugar, a sufficient quantity to sweeten it. 

-Mix. Dose for adults, a wine-glassful every hour till it operates. 

A?itibilious, or Aperient and Diaphoretic Pills. — Take of calo- 
mel, jalap, each twenty grains ; tartar emetic, two grains ; syrup or 
mucilage of gum Arabic, sufficient to form a mass ; make eight pills. 
Dose for adults, two at bed-time, and the dose repeated every hour 
in the morning until it operates sufficiently. — Or take four in the 
morning, and one every hour until the desired effect be obtained. 

Purgatives. — The drastics are the Croton oil, gamboge, aloes, 
calomel, jalap, rhubarb, and senna, the purgative infusion, purgative 
powder, stimulant purgative pills, and purgative electuary. The 
distinction, however, between laxatives and purgatives, is by no 
means easy, since by diminishing or increasing the dose of the 
former, they may, with some propriety, be considered as belonging 
to the first or second class. 



DISPENSATORY. 637 

Croton Oil. — This oil is obtained from the seeds of the Croton 
Tiglium ; a native of the East Indies. It is one of the greatest and 
most powerful cathartics, with which we are acquainted: Like all 
other active cathartics, it sometimes gripes the bowels. This effect 
may be relieved by drinking freely of chicken water, gruel, or flax- 
seed tea ; or, if necessary, by a little laudanum. The usual dose, 
for an adult, is one drop, but four or five drops are sometimes given. 
It may be given in syrup, or made into the form of pill with crumbs 
of bread — the latter form is preferable. 

Purgative Infusion. — Take of senna and manna, each, half an 
ounce ; salts, one ounce; ginger, one drachm ; boiling water, one pint. 
Dose for adults, one gill every hour or two, until it operates. 

Purgative Poivder. — Take of calomel and jalap, each, twenty 
grains, to be taken in the morning in syrup or molasses, by adults. 

Or, take of rhubarb and vitriolated tartar in fine powder, each one 
drachm; mix well together, and divide into four powders. — One 
taken going to bed, and another in the morning, will be found an 
efficacious remedy, whenever it is required to cleanse the stomach 
and bowels of bilious and other offensive matter. 

Stimulant Purgative Pills. — Take of calomel and gamboge 
each one drachm; syrup sufficient to form a mass. Beat them 
together, and then make twenty-four pills. Dose for adults, from 
three to six. 

Or, take of calomel, aloes, rhubarb, and soap, each, one drachm, 
syrup or mucilage of gum Arabic, sufficient to form a mass. — Beat 
them well together, and make forty-eight pills. Dose for adults from 
four to eight. 

Or, take of calomel and jalap, each, one drachm ; powdered gin- 
ger and soap, each, half a drachm ; mucilage or syrup sufficient to 
form a mass — divide into thirty pills. Dose for adults from four to 
eight. 

Aloetic Pills. — Take of Socotorine aloes, in the finest powder, 
one drachm and a half; Castile soap, one drachm; ginger, half a 
drachm. Beat them well together, and then add mucilage or syrup 
sufficient to form a mass — which is to be made into forty-eight pills. 
Dose for adults, two at bed-time, or a sufficient number to keep the 
bowels in a regular state. 

Purgative Electuary. — Take of jalap, one drachm ; cream of 
tartar, one ounce ; syrup or molasses as much as will give the whole 
a proper consistence. Dose for adults, from one to two tea-spoons 
full in the morning, to keep the bowels in a soluble state. 



633 DISPENSATORY. 



DIAPHORETICS. 



In the common language of the schools, the term diaphoretic, is 
restricted to those articles only which promote the insensible perspi- 
ration ; and such as occasion sweating, are distinguished by the ap- 
pellation of sudorifics. But, as in the medicines arranged under 
these titles we can discern no difference, except in the degree of 
force, or what arises from the manner of administration, we shall 
comprehend the whole under the head of diaphoretics. 

To promote perspiration it is essentially necessary that the patient 
should be confined to his bed. Let his pulse, and the temperature 
of the body, be carefully watched. It is a principle settled and fully 
recognised, never to resort to diaphoretics in fevers of an inflamma- 
tory species, till arterial action and general excitement are consider- 
ably reduced by previous venesection and evacuations by puking or 
purging. After this direct depletion, diaphoretics then come in with 
great advantage, and will commonly either mitigate or completely 
arrest the progress of the disease. 

In the exhibition of diaphoretics give diluent drinks, unless the 
stomach be irritable. This remark particularly applies to the anti- 
monial preparations, and some of the combinations of ipecacuanha. 
The temperature of the drinks must be regulated by that of the skin. 
The latter not being high, they should be warm, or even hot; but if 
the contrary prevail, they must be given cold. 

In the low stages of disease, while pursuing the diaphoretic plan, 
studiously avoid purging, unless circumstances imperiously require 
this remedy. It is very apt, in this state of the system, to check 
sweating, and to bring on an aggravation of the complaint. It does 
this by diverting action from the surface of the intestines, and by ex- 
posing the patient to cold. 

Diaphoretic Drops. — Take of sweet spirits of nitre and antimonial 
wine, each, one ounce. — Mix. Dose for adults, a tea-spoonful every 
two hours. If the stomach is in an irritable state, add only half the 
quantity of antimonial wine. 

Antimonial Wine. — Dose for adults, twenty drops every hour or 
two, till the proper effect be produced. 

Saline Julep or Mixture. — Take of lemon juice, one ounce ; vol- 
atile sal ammoniac, one drachm, or salt of tartar four scruples. 
After the effervescence, add syrup, two tea-spoons full ; simple cin- 
namon water, or tea, half an ounce, or spirits of lavender, thirty 
drops ; spring water, six ounces. — Mix. Dose for adults, two table- 
spoons full every three hours. 

Effervescing Draught. — Take fifteen grains of salt of wormwood, 



DISPENSATORY. 639 

or volatile sal ammoniac, dissolved in a table-spoonful of water, in 
one cup ; in another, two large tea-spoons full of lime juice, lemon 
juice, or one table-spoonful of very good vinegar, with one or two 
table-spoons full of water sweetened ; Dpur one to the other, and let 
the patient drink immediately while tSey effervesce. When made 
with fresh lime or lemon juice, this is an elegant, pleasant, and use- 
ful medicine in all fevers, and peculiarly effectual in removing nau- 
sea and vomiting ; it may be repeated every two or three hours. 

Spirit of Mindererus. — Take of volatile sal ammoniac, two 
drachms ; lemon juice or vinegar, half a pint, or as much as may be 
sufficient to saturate the volatile alkali. — Mix. A dose to be taken 
every two hours. 

Antimonial Solution. — Dose for adults, a table-spoonful every two 
hours as a diaphoretic. (See Emetics.) 

Antimonial Powders. — Take of tartar emetic, three grains ; nitre, 
two drachms. — Mix, and divide into twelve doses. One dose to be 
taken every two or three hours by adults. In obstinate cases, the 
addition of ten or twelve grains of calomel to the above recipe, will 
render the medicine more salutary. 

Febrifuge Powders. — Take of ipecacuanha, two scruples ; nitre 
two drachms. — Mix, and divide into twelve doses. One dose to be 
taken every two or three hours by adults. 

Febrifuge Mixture. — Take of nitre, two drachms ; lemon juice 
or vinegar, one ounce ; water, half a pint ; sugar, a sufficient quan- 
tity to sweeten it. — Mix. A wine-glassful to be taken by adults 
every two hours. It will be rendered more active by the addition 
of two drachms of antimonial wine, 

Dover'' s Powders. — Ipecacuanha, powdered, and opium, each, 
one drachm ; vitriolated tartar, in powder, one ounce. — The greatest 
possible pains should be taken to grind the mass to a completely fine 
powder. Nitre may be substituted for the vitriolated tartar, when 
that is not at hand. This powder is the most efficacious sudorific 
we possess. It is an admirable remedy for quieting the bowels, 
when affected by the exhibition of mercury, or any other cause. 
Dose for adults from ten to twenty grains every three or four hours. 

Camphorated Powders. — Take of camphor, two scruples; nitre, 
powdered, two drachms. Moisten the camphor with spirits, and 
after reducing it to a fine powder, add the nitre. Divide it into 
twelve doseS. One to be taken every two or three hours by adults. 

Infusion of Virginia S?iake Boot. — Snake root, half an ounce ; 



640 DISPENSATORY. 

boiling water, half a pint ; infuse for two hours in a covered vessel 
and strain. — Dose. A table-spoonful occasionally, taken warm. It 
is used to aid other diaphoretics, and in its effects, resembles camphor. 

Anodyne Sudorific DropW. — Take of laudanum half an ounce ; 
antimonial wine, one ounce. — Mix. Dose for adults, two tea-spoons 
full at bed-time. 

Anodyne Sudorific Bolus. — Take of opium, one grain and a half; 
ipecacuanha, ten grains : syrup or mucilage, sufficient to form a 
bolus. 

Or, take of opium, one grain and a half; tartar emetic one grain; 
or golden sulphur of antimony, two grains; mucilage sufficient to 
form a pill. To be taken by adults at bed-time. 

For children, the best means of procuring a perspiration is the 
tepid bath, succeeded by the use of a table-spoonful of saline julep, 
or the diaphoretic drops, every two or three hours. 

Besides the warm bath, the external stimulating diaphoretics are, 
friction, rubefacients, and blisters, which excite copious partial per- 
spiration, previously to their vesicat on. 

There are many vegetable substances which belong to this class 
of medicines, particularly the Virginia and seneca snake roots, sarsa- 
parilla, thoroughwort, &c. (See Materia Medica.) 



DEMULCENTS. 

Demulcent Drinks — Are those which sheath the acrimony of the 
humours, and render them mild, such as flax-seed tea, marsh-mallow 
tea ; mucilage of quince seeds, pith of sassafras, slippery elm, (see 
Materia Medica,) and gum Arabic. A solution of gum Arabic is 
made by boiling an ounce of picked gum Arabic, in a little more 
than a quart of water, until it be dissolved. All these are useful to 
sheath and defend very sensible parts from the irritation of acrid 
humours, as is the case in tickling cough, and common lax, or bloody 
flux, heat of urine, &c, in all which, the natural mucus of the parts 
is defective. 



ABSORBENTS. 

Absorbent Medicines — Are such as correct acidity in the stomach. 

Calcined Magnesia — One or two tea-spoons full to be taken oc- 
casionally mixed in milk or mucilage of gum Arabic, by adults. 

Prepared Chalk. — A tea-spoonful to be given in the same manner 
as magnesia. 



DISPENSATORY. 641 

I Ante Water. — A wine-glassful, with an equal quantity of new 
milk, to be taken occasionally by adults. 

Absorbent Mixture. — Take of chalk prepared, half an ounce ; 
gum Arabic, powdered, and white sugar, each, two drachms ; water, 
four ounces. Dose for adults, a table-spoonful every two or three 
hours. 

Absorbent and Aperient Mixture — Is made by adding one drachm 
of rhubarb in powder, or half an ounce of the tincture of rhubarb, to 
the above recipe. • 

Or, take of prepared chalk and magnesia, each, half an ounce ; 
sugar, two drachms ; rub them well together, then add mucilage of 
gum Arabic, two ounces ; weak cinnamon tea, four ounces. — Mix. 
Dose for children, from one to two tea-spoonsful. 



DIURETICS, 

Are remedies to promote the urinary discharge, which may take 
place, either by stimulating the kidneys, or by an invigoration of the 
powers of absorption, and especially in cases of dropsical effusion. 
It hence appears, that diuretics are of two species, though in which- 
ever mode they operate, it is by an action primarily on the stomach, 
extended to the absorbents or kidneys, according to the affinity of the 
article to the one or other of these parts. 

Mild Diuretics. — Of this class of medicines, nitre, by reducing 
the force of circulation, will be found eminently useful in febrile 
cases. Dose, ten or fifteen grains, for adults, every two or three 
hours. Conjoined with camphor, as in the camphorated powders, its 
diuretic effects, in some cases, is increased. 

Dulcified Spirits of Nitre. — Dose for adults, half an ounce every 
three or four hours. Unless this medicine be given in large doses, 
it will excite perspiration, rather than act as a diuretic. 

It is chiefly valuable in the cases of children. There is, indeed, 
scarcely any medicine which, in their complaints, we can substitute 
in its place, and it may be given to them, in the same proportion 
even in the earliest periods of life. 

Cream of Tartar. — Dose for adults, half an ounce, dissolved in a 
pint and a half of water, to be taken throughout the course of the 
day. It must be gradually increased, as the stomach becomes ac- 
customed to it. 

Of all the diuretic medicines, this is perhaps most fitted to those 
cases of dropsy which are accompanied with increased or febrile ac- 
tion of the pulse, though it here sometimes operates more effectually 
81 



G42 DISPENSATORY. 

when combined with jalap, as in the form of laxative electuary. 
(See Cathartics.) Dose for adults two tea-spoonsful every three or 
four hours, where we wish to evacuate large accumulations of fluid, 
and here an abstinence from drink must be enjoined. 

Salt of Tartar — Is considered, by some practitioners, a valuable 
diuretic, in doses of half a drachm, dissolved in water, three or four 
times a-day. By combining it with the infusion of Colurnbo, or 
some of the bitter tonics, its efficacy is very much improved. Thus 
exhibited, it is said to increase the diuretic effect, while at the same 
time it invigorates the system generally. 

Parsley. — The common parsley of our gardens is another valuable 
diuretic. A strong infusion of the roots in doses of a tea-cupful 
every two or three hours, is well adapted to relieve the ordinary sup- 
pression of urine. It is customary to unite with the parsley the 
seeds of the water melon. 

Diuretic Infusion. — Pound a handful of the kernels of pumpkin 
seeds or melon seeds, with a small quantity of hard white sugar, to 
a smooth paste; then add a quart of boiling water, and a quarter of 
an ounce of saltpetre, or half an ounce of sweet spirits of nitre, 
and rub them well together. This is a pleasant and mild diuretic, 
particularly useful where the discharge of urine is attended with 
heat and pain. A tea cupful may be taken every hour or two by 
adults. 

Diuretic Pills. — Take dried squills in fine powder and calomel, 
each, half a drachm ; mucilage of gum Arabic, sufficient to form a 
mass, and then make twenty pills, two of which are to be taken at 
bed time. The pills powerfully promote urine, and are very effi- 
cacious in carrying off cold, phlegmatic humours, in all dropsical 
swellings. When the squill alone is given, it may be taken in doses 
of two or three grains, three or four times a-day, in the form of pills, 
by adults. 

Oil of Juniper. — Dose for adults, ten drops in gruel. — (See Ma- 
teria Medica. See also, under this head, wild parsley, wild carrot, 
foxglove, and tobacco.) 

Stimulating Diuretics. — The Spanish fly promotes, as well as 
restrains, the urinary discharge. Exhibited in a state of excitement, 
or at any time in small doses, it most^ commonly occasions strangury. 
But taken in a reverse state of the 'system, or in large doses, it as 
constantly proves diuretic. Thus, in the weaker forms of dropsy, 
two, three, or four drachms of the tincture, given in divided doses 
during the twenty -four hours, will produce the most copious evacu- 
ations of urine. 



DISPENSATORY. - 643 



EXPECTORANTS. 

Expectorants have been denned those medicines which facilitate 
or promote the excretion of mucus or other fluids, from the pulmo- 
nary system or lungs. 

Expectorants are employed when the mucus is too thin and 
acrid, when too viscid, or when the excretories are not sufficiently 
irritable to propel their contents. Where the mucus is thin and 
acrid, inflammation generally exists, and in such cases mucilaginous 
drinks, as flax-seed tea, mucilage of gum Arabic, or slippery elm, 
Iceland moss, or syrup, liquorice, antimonials, and nauseating medi- 
cines are employed. Oils differently prepared, and jellies, are also 
useful. Independently of inflammation, the mucus is sometimes too 
thin and acrid, from too great irritability of the vessels of the bron- 
chial glands, and we then employ opiates and stimulating medicines, 
as mustard, horse-radish, seneca, squills, garlic, Indian turnip, mea- 
dow saffron, and tobacco, (See Materia Medica.) When the ex- 
pectoration is too viscid, or the vessels not sufficiently irritable to assist 
the excretion, expectorants, strictly so called, are useful. These are 
the more stimulating medicines just mentioned ; to which may be 
added all the variety of fetid gums, and the turpentines, including 
the balsams. Steams of warm water, impregnated with vinegar, 
aromatic herbs, and ether, are adapted to the same purpose. 

Nitric Lac Ammoniac. — Pour very gradually two drachms of ni- 
tric acid, diluted in eight ounces of water, on two drachms of ammo- 
niac, and triturate them in a glass mortar till the gum is dissolved , 
forming a milky fluid. Of this a table-spoonful may be taken every 
two or three hours in sweetened water. Laudanum, in some cases 
may be usefully added. 

Pectoral Mixture. — Gum ammoniac, two drachms; syrup oi 
squills, half an ounce ; laudanum, fifty drops ; spring water, six 
ounces. Reduce the gum to powder in a marble mortar, and gra- 
dually add the water, and triturate till the gum is dissolved, then 
strain from the impurities and add the other articles. Dose, a table- 
spoonful every two or three hours, for adults. 

Or, take of sweet oil, one ounce ; rain or soft water, half a pint ; 
salt of tartar, five grains ; white sugar, half an ounce. Dissolve the 
salt of tartar and the sugar in the water, and afterwards add the oil, 
when, by agitating the phial, a mixture will be formed of cream-like 
appearance. To this add paregoric elixir, half an ounce. Dose, a 
table-spoonful every hour or two. 

Pectoral Emulsion. — Take of oil of almonds, or pure sweet oil, 
one ounce; barley-water, six ounces; best white sugar and gum 



644 DISPENSATORY. 

Arabic, powdered, of each half an ounce; laudanum, forty drops, 
Incorporate the sugar and gum Arabic together in a mortal- with a 
small quantity of the barley-water, then gradually mix the oil, and 
afterwards add, by little at a time, the remainder of the water with 
the laudanum. One or two table-spoonsful of this emulsion may 
be taken frequently. 

Or, take of the best purified honey and pure sweet oil, each, two 
ounces ; fresh lemon juice, one ounce ; syrup and paregoric, each, 
half an ounce. Mix, to form an emulsion. Dose, a tea-spoonful 
whenever the cough is most troublesome. 

Cough Mixture. — Take of paregoric elixir, one ounce ; powdered 
gum Arabic, one ounce; simple water, two ounces; sweet spirit of 
nitre, two drachms; antimonial wine, one drachm. Mix and dis- 
solve. Dose, one tablespoonful to be taken whenever the cough is 
troublesome. But, in the first stage of catarrh, when inflammatory 
symptoms are present, this and all opiates, are improper. 

Or, take of elixir paregoric, one ounce and a half; antimonial 
wine and syrup of squills, each one ounce; lac ammoniac, four 
ounces; syrup bal. tolu, one ounce. Dose, half a table-spoonful 
every two or three hours for adults. 

Or, take of tincture of opium, one drachm ; wine of ipecacuanha, 
half a drachm ; oxymel of squills half an ounce. — Mix. Dose, for 
adults, a tea-spoonful every two hours while the cough is severe. 

Domestic Remedies for Whooping- Cough. — Dissolve thirty 
grains of salt of tartar in a gill of water, add to it ten grains of co- 
chineal finely powdered, sweeten this with fine sugar, and give an 
infant a tea-spoonful four times a-day. To a child of two or three 
years old, two tea-spoonsful ; from four years and upwards, a table- 
spoonful or more may be taken. The relief is said to be immediate, 
and in general within five or six days. 

Or, take equal portions of new milk, and the lie strained from 
hickory ashes, of which one table-spoonful maybe given every hour 
through the day to a child of seven or eight years old — This reme- 
dy is also strongly recommended. 

Pectoral Lozenges. — Take of purified opium, two scruples; tinc- 
ture of balsam of tolu, two drachms; syrup, composed of one part 
of water, and two parts of white sugar, four ounces ; refined Spanish 
liquorice, previously moistened with a little warm water, so as to 
make it soft ; gum Arabic, in fine powder, each, two ounces and a 
half; emetic tartar, eight grains. Rub the opium and the emetic 
tartar with the tincture and syrup until the former is perfectly dis- 
solved, then add the liquorice; softened with wann water, and whilst 
beating them together, gradually sprinkle in the gum Arabic. Di- 
vide the mass into lozenges or troches ; each weighing ten grains, 
and exsiccate them gradually in the air. One may be put in the 



DISPENSATORY. 645 

mouth and gradually dissolved, every hour or two when the cough 
is troublesome. 

Nitrous Lozenges. — Take of purified nitre, two drachms ; re- 
fined sugar, reduced to a fine powder, six drachms ; pulverized gum 
tragacanth, three drachms. — Beat these together with a small por- 
tion of water, until they are intimately mixed, and form a coherent 
mass, which may be divided into moderated sized troches or lozenges, 
to be dried by means of a gentle heat. In cases of quinsy or sore 
throat, one of these lozenges frequently put in the mouth and suffer- 
ed gradually to dissolve, will be found very beneficial. 



ANODYNES. 

Anodynes are medicines which ease pain and procure sleep. 

Opium. — Of all the articles of the Materia Medica, this is, per- 
haps, the most extensively useful ; there being scarcely one morbid 
affection, or disordered condition of the system, in which, under 
certain circumstances, it is not exhibited either alone or in combina- 
tion. Opium, the product of the poppy, with some persons, leaves 
unpleasant effects, and with such, the lettuce opium, (See Materia 
Medica,) should be employed. 

Opiate Pills. — Take of pure opium, and powder of cinnamon, or 
ginger,. each, twelve grains; mucilage or syrup sufficient to make 
them into twelve pills. Dose, for adults, one or two at bed-time. 

Anodyne Draught. — Take of laudanum, a tea-spoonful ; syrup, 
two tea-spoons full ; cinnamon, or herb tea, one ounce. — Mix. This 
to be taken at bed-time by an adult. When laudanum disagrees in 
the ordinary quantity, it may often be given with much advantage 
in doses of five or six drops every hour till the proper effect be pro- 
duced ; or it may be given in vinegar, whey, or conjoined with the 
antimonial wine, as in the form of the anodyne sudorific draught 
(See Diaphoretics.) 

As laudanum is extremely prejudicial to children, it ought not to 
be administered to them, except under peculiar circumstances. In- 
stead of its internal use, a little of it should be rubbed on the back- 
bone ; or the same effects may be produced by rubbing on that part 
a tea-spoonful of anodyne balsam. 

When laudanum is prescribed by way of injection, the proportion 
must be more than double what can be given by the mouth. 

Paregoric. — Dose, for adults, one or two tea-spoons full, in a cup 
of tea or gruel. 



646 DISPENSATORY. 

Morphine. — For this article, as well as for the quinine and most 
of the other improvements, in pharmacy and chemistry, we are in- 
debted to the skill and industry of the French chemists. It is an 
alkali obtained from opium, and is that principle in opium which 
quiets irritability and disposes to sleep, without producing those dis- 
agreeable effects, which sometimes arise, from any other preparation 
of that valuable medicine. Hence it is particularly valuable to those 
with whom opium generally disagrees. Morphine is used in medi- 
cine in combination with sulphuric, or acetic acid, forming the sul- 
phate, or the acetate of morphine, of which the sulphate is to be pre- 
pared. They are used in solution ; which, may be obtained from 
any apothecary, and is thus prepared : — Take of sulphate, or acetate 
of morphine, sixteen grains, water one ounce, acetic acid, or strong 
vinegar five to six drops, alcohol one draehm. — Mix. 

The dose for an adult is from six to twenty-four drops of the so- 
lution, or one-fourth to one-half grain of the morphine itself, in pills 
or syrup. 



ANTI-SPASMODICS 

As the causes of spasms differ essentially, the remedies must 
equally differ. Bleeding, mercury, warm bathing, blister, opiates, 
camphor, volatile alkali, musk, castor, assafoetida, garlic, ether, wine, 
and spirits, bark, steel, and other tonics, are the remedies usually re- 
sorted to. 

In the choice of these, we employ the sedatives and ftetids to 
shorten the fit ; and the stimulants and tonics to prevent returns. 

Gum Pills. — Take assafoetida, three parts ; gum ammonia, two 
parts \ camphor, one part \ beat them well together, and with as 
much syrup as is necessary, make into pills of the size of a common 
pea, from three to five may be taken at a dose, and repeated as often 
as shall be found necessary ; not, however, exceeding three or four 
doses in a day. This is a powerful antispasmodic, and very useful 
in all nervous and hysterical complaints. When it is wished to 
render the mass purgative, which is generally proper, add as much 
socotrine aloes as of camphor. 



CORDIALS. 

A glass of wine or a little brandy toddy. 

Compound Spirits of Lavender. — Dose, for adults, a tea-spoonful 
on a lump of sugar, to be dissolved in the mouth, and gradually 
swallowed. 



DISPENSATORY. 647 

Cordial Mixture. — Take of aromatic spirit of hartshorn, two 
water, two ounces ; spring water, three ounces. — Mix. The dose, 
for adults, a table-spoonful now and then. 

Cordial Draught. — Take of volatile tincture of valerian, one 
drachm; simple syrup, water, of each four tea-spoons full. — Mix 
them together. To be taken at once by adults. 

Cordial Drops. — Take of paregoric elixir, volatile tincture of va- 
lerian, of each equal parts. Mix them well together. Dose, one 
tea-spoonful in a glass of water, for adults. 

For children the best cordial is white wine whey. 



STIMULANTS. 

In relation to general stimulants, there is a distinction too impor- 
tant to be overlooked. We have a set distinguished by great diffu- 
sibility, and which, nearly as soon as exhibited, occasion universal 
excitement over the body; and there is a second section, by which 
tone is imparted, though very slowly, and by a long administration. 
The diffusible are very transient in their effects, while such as are 
more gradual in their operation, produce permanent or enduring im- 
pressions, and are called tonics. 

As in the administration of stimulants, we hope to overcome an 
existing action, by exciting a new and stronger one, it is obvious 
that they can only be resorted to with any hope of advantage, in the 
feeble shapes of disease, or in more violent forms, reduced by pre- 
vious evacuations. But, in determining the exact point at which to 
commence the use of stimulants, we may also be aided by watching 
their operation. Being ill-timed, they commonly produce pain in 
the head, or delirious wanderings, or morbid vigilance, or stricture 
of the breast, restlessness and anxiety, with a hot dry skin, parched 
tongue, and a quick, small, and corded pulse. 

In the administration of stimuli, we should endeavour to graduate 
the article to the state of excitability. 

This is a point of infinitely greater importance than is commonly 
imagined. It is not always the most active article produces the 
greatest effects. In the low states of disease, we have witnessed, in 
some instances, more effects from wine whey, than strong toddy. 
This proceeds from the article being in unison with the condition of 
the system. 

Narcotics. — That the purer narcotics are endowed with a stimu- 
lant power, is very satisfactorily proved by the operation of opium. 

Exhibited in a moderate dose, the purer narcotics excite activity 
both of body and of mind. But to command their stimulant powei , 
they ought to be given in small doses, frequently repeated, and 



648 DISPENSATORY. 

drachms; compound spirit of lavender, three drachms; cinnamon 
gradually increased, and the excitement which they enkindle is thus 
sustained. But when the design is to mitigate pain, or to procure 
sleep, or to relieve irritation, or deaden sensibility, they should be 
exhibited in a full dose, and at more distant intervals. It should be 
remembered that the indications, chiefly, which narcotics are capa- 
ble of fulfilling, are to excite and support the actions of the system, 
to assuage pain, and allay irritation, to relieve spasmodic affections 
and to induce sleep, and to check the morbidly increased secretions 
and excretions. 

Volatile Sal Ammoniac. — In a great variety of febrile affections 
this medicine has been prescribed, though it is in the low, or typhus 
fevers, that it is chiefly employed. 

In one respect the volatile alkali differs from every article of the 
class to which it is attached, and, it would seem, from all other me- 
dicines. The peculiarity to which we allude is this, that the excite- 
ment it raises approaches more nearly to that of healthy action, and 
hence it may be recurred to earlier than stimulants generally, in the 
inflammatory affections, and with greater safety in mixed cases so 
equivocal or obscure, as to render uncertain the propriety of stimu- 
lation. It may be given in the shape of a pill or julep, in the dose 
of five or ten grains, every hour or two, according to circumstances. 
The best form, however, is the latter, which maybe made agreeably 
to the annexed prescription. 

Take of volatile sal ammoniac, two scruples; gum Arabic, white 
sugar, each one drachm ; oil of cinnamon, five drops ; spring water, 
five ounces. — Mix. Dose, for adults, a table- spoonful every two 
hours. 

Camphor. — No medicine, perhaps, has been prescribed for a 
greater variety of purposes than camphor. In every modification 
of febrile action, when approaching to the typhoid state, camphor 
has been resorted to, and not without success. It excites perspira- 
tion, quiets nervous irritation, removes delirium, and abates the force 
of the disease. Camphor is best exhibited in the form of julep or 
mixture. 

Camphorated Julep, or Mixture. — Take of camphor, one drachm ; 
gum Arabic, two drachms; white sugar, half an ounce; water, half 
a pint. Moisten the camphor with spirits, and after reducing it to a 
powder, add the gum Arabic and sugar, and then, by degrees, pour 
on the water, while triturating them together in a mortar. Dose, for 
adults, a table-spoonful every two or three hours. 

Or, take camphor, one drachm ; myrrh, half a drachm ; white 
sugar, two drachms ; spring water, six ounces. — Dose, for adults, a 
table-spoonful. The mixture, thus made, is perfectly transparent 
and very palatable. Of late, however, the solution, or rather sus- 



DISPENSATORY. 649 

pension of camphor in milk, has nearly superseded all other prepara- 
tions of the medicine in practice. It is made by simple trituration. 
The dose of camphor is from five to ten grains, to be repeated once 
in two or four hours, according to circumstances. 

Pills of Camphor and Assafoetida. — Take of camphor, assafoetida, 
each one drachm ; moisten the camphor with a few drops of alcohol, 
unite them together, and make thirty-six pills. It is sometimes ad- 
visable to add half a drachm of calomel to the above. 

This is an admirable combination, as well as camphor united with 
opium, for that species of mania, excited by frequent intoxication. 
Dose, for adults, two pills every three or four hours. 

Spirit of Turpentine. — This is one of the most active and diffu- 
sible of stimulants. In the typhus or low fevers, when other diffusible 
stimuli are given, much may be expected from turpentine. It 
promptly relieves gout in the stomach, and is particularly suited to 
periodical colics, arising from flatulence. The dose of the spirit of 
turpentine, in those cases, is about a drachm, to be repeated, more or 
less frequently, according to the nature of the disease, and the best 
mode of giving it is alone, or with a small portion of water. By at- 
tempting to blend it with mucilage, or any such vehicle, it seems in 
some degree to be volatilized, and is thereby rendered more pungent 
to the fauces, and difficult to swallow. 

Aromatics. — Ginger, cinnamon, cloves, nutmegs, allspice, and all 
the aromatics are more or less stimulant. 

Wines. — As a cordial and tonic, wine is often directed in various 
chronic cases, attended with debility, and also in the convalescence 
from acute diseases. Compared with ardent spirits, the action of 
wine is infinitely less injurious in a state of health, and as a remedy 
in disease, it evinces the same superiority. The effect it produces is 
slower, and more permanent, combining also qualities which, while 
they blunt the ardency of the stimulus, afford no inconsiderable por- 
tion of nutriment; by which the system is sustained and invigorated. 
In exhibiting wine we are cautiously to regulate its administration 
by the effects it manifests, since, urged too far, it might induce indi- 
rect debility, and thus cause irreparable mischief. Wine may always 
be considered as doing good, when it renders the pulse fuller, slower, 
and stronger, when it removes or lessens delirium, calms irritation, 
and composes to sleep. But if, on the contrary, it accelerate the 
pulse, flush the countenance, increase the temperature of the skin, 
excite thirst, aggravate delirium, or restlessness, and thus occasion an 
exacerbation of the disease, the evidence of its injurious tendency is 
no less decisive, and we should at once withdraw it altogether, or 
reduce the quantity. 
82 



650 DISPENSATORY. 



ASTRINGENTS. 

Astringent Medicines are employed for checking hemorrhages, 
and immoderate evacuations of every kind. 

Infusion of Roses. — Upon a large handful of dried red rose-leaves, 
pour a pint of boiling water ; let them infuse half an hour. 

Infusion of Oak Bark. — Upon a handful of white oak bark, shred 
fine, pour a quart of boiling water ; let it stand one hour, then boil a 
few minutes. 

Infusion of Galls. — Upon a quarter of an ounce of galls, pour a 
quart of boiling water; let them infuse one hour, then boil for a few 
minutes. A small quantity of cinnamon adds greatly to the flavour 
of this and the oak bark ; and acidulating any of them with the acid 
of vitriol, renders it more efficacious : they should be taken cold, to 
the quantity of half a gill, or a wine-glassful, every hour or two. 

Astringent Decoction. — Take of cinnamon, three drachms ; Pe- 
ruvian bark, one ounce; spring water, three pints. Boil these 
together till only one half remains; then strain oft the liquor after it 
has cooled, and add elixir vitriol, one drachm. Dose, for adults, two 
ounces thrice a-day. 

Astringent Mixture. — Take of the infusion of galls, four ounces ; 
prepared chalk, two drachms; laudanum, forty drops. — Mix. Dose, 
for adults, a table-spoonful every three or four hours. 

Or, take of tincture of kino and prepared chalk, each, half an 
ounce; laudanum, forty drops; boiling water, four ounces. — Mix. 
Dose, for adults, a table-spoonful eveiy two or three hours. 

Vitriolic Solution. — Take of white vitriol, three drachms; alum, 
two drachms; spirit of lavender, half an ounce; boiling water, one 
pint. — Mix. Dose, for adults, a large table-spoonful every morning, 
on an empty stomach, without diluting it, and in some cases to be 
repeated every six hours. When evacuations are required, the 
quantity of alum may be diminished, or even entirely omitted ; and 
when great astringency is required, the quantity of alum is to be 
increased, and the vitriol to be diminished. 

Pills of Sugar of Lead, fyc. — Take of sugar of lead and ipecacu- 
anha, each, six grains ; opium, one grain ; syrup sufficient to form a 
mass. Divide in four parts; one pill to be taken every three hours, 
until the hemorrhage cease. 



DISPENSATORY. 651 

Anti-dysenteric Mixture. — Take of lemon juice or best vinegar, 
two ounces; common salt, as much as the acid will dissolve; strong 
mint tea, half a pint ; white sugar, sufficient to sweeten it. — Mix, 
Dose, for adults, a wine-glassful every two or four hours. 



TONICS. 

Tonic Medicines are those which increase the tone or strength 
of the body. In the widest acceptation of the term, this class of 
remedies is extremely extensive, since it includes every means 
which invigorates the powers of life. Among the means to over- 
come debility, or to invigorate the system, is properly regulated diet. 
The diet should always be accommodated to the state of the system ; 
and whatever may be the nature of the case, the patient should 
eat much more frequently than the common meals. The stomach 
has been pronounced, by a very sagacious observer, to be in one 
respect like a school-boy, who is always doing mischief when not 
employed. 

After recovery from acute diseases, it should at first consist of the 
lightest vegetable matter, and especially the farinaceous articles, 
such as rice, tapioca, arrow root, and sago. To these may succeed 
eggs, oysters, game, and the white poultry, and finally, ham, beef, 
and mutton. As a general rule, solid food is preferable to fluids. It 
is usually more comfortable to the stomach, and restores strength 
with greater rapidity. In selecting the articles of diet, the palate of 
the person himself should be consulted, since the pleasure which is 
received in eating, is of itself no ordinary stimulus, and particularly 
to a very debilitated system. 

Next to diet, in point of efficacy as a tonic, are the warm and cold 
baths. Though different in temperature, they produce effects not 
very dissimilar. Each, when judiciously managed, will very rapidly, 
in many instances, invigorate the body. — (Seepages 32 and 33.) 

As a tonic, exercise is undoubtedly among the most decisively 
useful, and has been divided into two parts, active and passive. — It 
is proper, in extreme debility, or in the first stage of convalescence 
from an acute disease, to begin with the second species. — This con- 
sists chiefly of frictions, which may be made with the naked hand, or 
with a brush, either alone, or with the addition of some stimulating 
matter. To rub at least once a-day for half an hour or more, the 
whole body with fine dry salt, creates a universal glow, renders the 
skin smooth and florid, imparts vigour to the muscles, improves ap- 
petite and the powers of digestion, and in all its tendencies is highly 
salutary. When the patient is able to take exercise, let the mode 
be adapted as much as possible to the seats of debility or disease ; 
but be careful of fatigue. 

Medicinal Tonics. — Of this class, nature has been lavish in her 



652 DISPENSATORY. 

supplies. Two of her kingdoms, at least, are exuberant in articles 
possessed of such powers ; namely : the vegetable and mineral. 

Peruvian Bark — Is one of the best strengthening remedies ; it 
may be taken in powder alone, or conjoined with one-fourth of the 
Virginia snake root, in doses of a tea-spoonful, five or six times a-day. 
When the. doses are to be frequently repeated, as soon as one is 
taken, put another, with a small quantity of wine or water, into a 
glass, by which means it will become equally and universally moist, 
and may be mixed more easily and more smoothly. As many per- 
sons cannot take the bark in substance, it should be exhibited in 
infusion, or decoction. 

Cold Infusio?i of Bark. — Mix one ounce and a half of bark in 
powder in a quart of water; let it stand twenty-four hours, occasion- 
ally shaking the bottle, and then strain off the liquor. Dose, for 
adults, a wine-glassful every two hours. 

Decoction of Bark. — Put two ounces of coarsely powdered bark 
into a quart bottle of water, which, after being corked, is to be 
placed in a pot of water, and boiled for two or more hours. This is 
a very elegant preparation, and one of considerable efficacy. The 
dose of the decoction, for adults, is a wine-glassful every two or 
three hours. 

To correct some inconveniences occasionally produced by the 
bark, it is frequently combined with other remedies. When it 
excites vomiting, or oppresses the stomach, cinnamon, or some aro- 
matic, must be added ; when it purges, opium ; when it induces 
constipation, rhubarb; and where there is much acidity of the 
stomach, magnesia, or small portions of the mineral or vegetable 
alkali. As children cannot be induced to take the bark in sufficient 
quantities, it should be administered in the form of clysters, united 
with a little milk or flax-seed tea, to which may be added a little 
laudanum. Applied externally by means of a bark jacket, (See 
page 166,) it will be found to have as salutary an effect as when 
exhibited internally. 

Quinine. — For this article we are indebted to the French chemists. 
It is an alkali, obtained from the Peruvian bark, and is used in 
medicine in combination with sulphuric acid, forming the sulphate 
of quinine. It is the most powerful tonic with which we are 
acquainted, and so superior is it considered to the bark, that it has 
almost entirely driven that article out of use. Its dose being ex- 
tremely small, and its taste that of a simple bitter, it will not disagree 
with the stomach when any tonic would be proper, and it may be 
given to children of any age. Like every other tonic, it should not 
be given during active fever, nor until the bowels are thoroughly 
cleansed. Dose, one grain every hour or two, according to circum- 



DISPENSATORY. 653 

stances. It may be taken mixed in syrup, or made into pills with 
crumbs of bread, or in solution. The solution is prepared as follows. 

Solution of Sulphate of Quinine. — Take of sulphate of quinine, 
eight grains; water, one ounce; mix, and then add sulphuric acid, 
or elixir vitriol, from twenty to thirty drops. Dose, for adults, a tea- 
spoonful every hour or two. 

Pills of Sulphate of Quinine. — Take of sulphate of quinine, 
twelve grains; crumbs of corn bread, or mucilage of gum Arabic, a 
sufficient quantity to make twelve pills. Dose, for adults, one every 
hour or two. It would sometimes be advantageous to add a little 
rhubarb to these pills, to prevent costiveness. 

Columbo. — Dose, for adults, in powder, a tea-spoonful ; to be given 
in mint tea or water. 

Infusion of Columbo. — Take of Columbo, bruised, one ounce ; 
boiling water, one pint. Dose, for adults, a large wine-glassful every 
two hours. This bitter is peculiarly serviceable in cases of weak 
stomachs and bowels, attended with lax, and abounding in bilious 
crudities. 

Infusion cf Gentian. — Put half an ounce of gentian, bruised, and 
two drachms of orange peel, in a pint of cold water for twelve hours, 
then strain ; when used in hot weather, add half a gill of brandy. 
Dose, for^adults, a wine-glassful three times a-day. Bitters are pro- 
perly considered strengthening remedies, when not continued too 
long ; they improve the appetite, and strengthen the stomach and 
bowels, but a constant and long-continued use of them, or any one 
tonic, is generally prejudicial. 

The black oak bark, the dogwood bark, the wild cherry tree, and 
thorough wort, (see Materia Medica,) claim our attention as tonics. 

Mineral Tonics. — Iron, in its operation on the system, evinces all 
the effects of a powerful and permanent tonic : no medicine, perhaps, 
leaving behind it such lasting impressions. The indications, there- 
fore, that it is calculated to fulfil, are numerous and important, 
most of which, however, are embraced within the sphere of chronic 
debility. 

,. Iron Filings — If made with a fine file, will require no other pre- 
parations ; the dose, for adults, is six or eight grains, or about as 
much as a common pinch of snuff, with an equal quantity of pow- 
dered ginger, to be mixed in syrup or molasses, and taken two or 
three times in a day. In this simple form, iron acts as well as in 
any more laborious preparation. It is a most useful tonic in all pale 
and relaxed habits, subject to watery swellings; particularly for chil- 



654 DISPENSATORY. 

dren of this description, with pale faces and distended bellies, whose 
complaints are frequently accompanied by worms. The doses for 
young and old, provided the filings be made with a fine file, may be 
much the same, as no more acts than what is dissolved. The rust 
and tincture of steel are employed with the same view. 

Tonic Powders. — Take of Columbo,in powder, and rust of steel, 
each, one ounce ; unite them well together in a mortar, and then di- 
vide into forty-eight doses— one to be taken by adults, thrice a-day. 

Tonic Pills. — Add to half an ounce of the tonic powder, a suffi- 
cient quantity of mucilage to form a mass, and make pills of an 
ordinary size. Three or four of them, or the number constituting a 
dose, to be taken thrice a-day. In cases of debilitated stomach, an 
equal quantity of powdered ginger may be added to the above. 

Chalybeate Wine. — Put rust of steel, one ounce and a half; 
orange peel and gentian root, each half an ounce, into a bottle of 
wine. The vessel containing these ingredients is to be exposed to 
the sun, or near the fire, for three days, and to be repeatedly shaken 
during this time. This preparation is an excellent stomachic, and 
agreeable tonic. Dose, for adults, two or three tea-spoonsful thrice 
a-day. 

Blue Vitriol, or Sulphate of Copper. — The fourth of a grain, 
united to a small portion of opium, given three or four times a-day, 
gradually increasing the dose, is celebrated as a valuable remedy for 
obstinate intermittents. White vitriol, in doses from three to five 
grains, for adults, in the form of pills, is also considered highly useful 
as a tonic. 

Solution of Arsenic. — This is a valuable tonic, and may be given 
with perfect safety, cautiously administered, to persons of every age. 

Pills of Sulphate of Quinine. — Take of sulphate of quinine, 
twelve grains; mucilage of gum Arabic, a sufficient quantity to make 
twelve pills. Dose for adults, one every hour. 

Solution of Sulphate of Quinine.— Take of sulphate of quinine, 
eight grains; powdered gum Arabic, thirty grains; cinnamon or 
ginger tea, one ounce. — Mix gradually. Dose, for adults, a tea- 
spoonful every hour, observing to shake the mixture just before using 
it. This is an excellent anti-febrifuge and tonic. 

Nitric Acid, as well as Elixir Vitriol, given in doses from ten 
to twenty drops, in a glass of sweetened water, thrice a-day, will be 
found very pleasant and useful tonics. They speedily quicken the 
appetite, and restore tone to the digestive organs. 



DISPENSATORY. 655 



ALTERATIVES. 

Alteratives — Are those medicines supposed to correct the acrimony 
which appears on eruptions of the skin, and in removing venereal 
complaints. These are almost exclusively mercurials, assisted by 
the warm bath, sarsaparilla, mezereon, slippery elm, lobelia, (See 
Materia Medica^) nitric acid, tar water, &c. 

Mercurial Pills. — Take of calomel, one drachm ; opium and 
tartar emetic, each, ten grains ; crumbs of bread, a small quantity ; 
syrup, or mucilage of gum Arabic, sufficient to form a mass. Divide 
into forty parts ; one pill to be taken night and morning by adults. 

Mercurial Solution. — Take of corrosive sublimate, twenty-four 
grains; laudanum, half an ounce; spirits, one pint and a half. — Mix. 
Dose, for adults, one table-spoonful morning and night 

Calomel — In doses of one or two grains, given every night, or 
every other night, drinking with it the following diet drink. These, 
together, make a powerful alterative for blotches on the skin, foul 
eruptions, and all other cases, in which the object is to remove ob- 
structions, and sweeten the humours. An occasional warm bath 
greatly promotes their good effects, whilst, at the same time, it con- 
tributes to prevent the mercury attacking the mouth, and bringing 
on salivation, which, during the use of mercury, must be carefully 
watched and guarded against, by avoiding cold, and suspending the 
medicine, from time to time, for a few days. 

Alterative Diet Drink. — Boil one ounce of the borings of lig- 
numvitse, and two ounces of split sarsaparilla, in three pints of water 
until it comes to a quart ; then strain it through linen, to be drunk in 
one or two days, by divided doses. The sarsaparilla, which is the 
least efficacious, is by far the most expensive article in this diet 
drink; it may, therefore, be omitted, adding in its place half an 
ounce more of lignumvitae, or two ounces of parsley roots. In either 
case, a small handful of stoned raisins, or two or three sliced figs, or 
half an ounce of liquorice root, will render it more agreeable. 

Nitric Acid, diluted. — Take of nitric acid, two drachms ; water, 
one quart. — Mix. As this acid is not always to be got of equal 
strength, it would be best to make a quart of water as sour with it as 
can be drunk ; which quantity sweetened, may be taken daily by 
adults, in doses of a wine-glassful every hour or two. To prevent 
its injuring the teeth, it should be sucked through a quill, or its sharp- 
ness may be obtunded by washing the mouth with milk, or muci- 
lage of gum Arabic. 

Nitric acid is diffusible in its operations, pervading every part of 



656 DISPENSATORY. 

the system, and imparting more or less vigour to all the functions. 
It is, hence, an exceedingly useful remedy in a great variety of af- 
fections. Of these, perhaps, the most striking are certain forms of 
inflammation of the liver; to most glandular diseases, it is, indeed, 
well adapted. Where there is too much debility to justify the use 
of mercury, or when it has already been used ineffectually, it is un- 
questionably the best medicine that can be administered, and, there- 
fore, should be uniformly employed in such cases. 



TINCTURES, ELIXIRS, &c. 

Laudanum. — Take of purified opium, two ounces ; brandy, two 
pints. Digest for eight or ten days, frequently shaking the bottle, 
then strain off the tincture. 

Tincture of Rhubarb. — Take of Rhubarb, three ounces ; lesset 
cardamom seeds, or ginger, bruised, half an ounce; brandy or rum, 
two pints. Digest for eight or ten days, and then strain. 

Tincture of Bark. — Take of Peruvian bark, powdered, two 
ounces ; orange peel and Virginia snake-root, each half an ounce ; 
brandy or rum, two pints. Digest for eight or ten days, and then 
strain. 

Tincture of Columbo. — Take of Columbo root, bruised, three 
ounces ; brandy, two pints. Digest for several days, and strain. 

Tincture of Foxglove. — Take of dried leaves of foxglove, one 
ounce ; brandy half a pint. Digest for a week, and filter through 
paper. 

Tincture of Cantharides. — Take of cantharides, bruised, two 
drachms, brandy, one pint. Digest for seven or eight days, and 
strain. 

Tincture of Myrrh. — Take of myrrh in powder, one ounce and 
a half; spirits, one pint. Digest for seven days, and strain. 

Paregoric Elixir. — Take of purified opium, flowers of Benzoin, 
camphor, and essential oil of annis-seed, each, two drachms ; brandy, 
two pints. Digest for eight or ten days, frequently shaking the bot- 
tle, and then strain the elixir. 

Turlington's Balsam. — Take of Benzoin, three ounces ; balsam 
of tolu, one ounce ; aloes, half an ounce ; brandy, two pints. — Digest 
for seven days, and strain. 

Rheumatic Tincture.— -Take of gum guaiacum, and vitriolated 



DISPENSATORY. 657 

tartar, in powder, each, three ounces ; spirits, two pints. Digest for 
eight or ten days, and strain. A dose to he taken twice or thrice 
a-day. 

Bitters. — Take of gentian root, two ounces ; orange peel, and co- 
riander seeds, each, one ounce ; brandy, two pints. Digest for se- 
veral days, and then strain. 

Camphorated Spirits. — Take of camphor, two ounces ; brandy, 
one pint. Mix them together, that the camphor may be dissolved. 

Antimonial Wine. — Take of tartar emetic, one drachm ; boiling 
water, two ounces; wine, one pint. Dissolve the tartar emetic in 
the water, and when cold, add the wine. Dose, for adults, two tea- 
spoonsful every fifteen minutes, until it excites vomiting. To has- 
ten its operation, the patient should drink freely of warm water. As 
a diaphoretic, it may be given in doses, from twenty to thirty drops, 
every two or three hours. 

Domestic Remedies for Rheumatism. — Take of sarsaparilla and 
walnut shells, each, half a pound; antimony, half an ounce sus- 
pended in a bag ; water, three quarts. Simmer slowly by the fire 
down to two quarts. Strain and use a pint in broken doses daily. 

Or, take a large handful of rattle-snake root, bruised ; spirit, one 
quart; let it steep by the fire for several days, frequently shaking the 
bottle. Of this a wine-glassful is to be taken night and morning. 

Saturated Solution of Arsenic. — Take of arsenic, in powder, 
about one drachm ; water, half a pint. Boil it for half an hour in a 
Florence flask, or in a tin saucepan, let it stand to subside, and 
when cold, filter it through paper. To two ounces of this solution, 
add half an ounce of spirit of lavender. A dose to be taken twice 
or thrice a-day. 

Lime -Water. — Pour two gallons of water, gradually, upon a 
pound of fresh burnt quick-lime, and when the ebullition ceases, stir 
them well together ; then suffer the whole to stand at rest till the 
lime has settled ; after which strain off the clear liquor, and keep it 
in vessels closely stopt. Calcined oyster-shells may be used instead 
of quick-lime. 

Tar- Water. — Pour a gallon of water on two pounds of tar, and 
stir them strongly together with a wooden rod. When they have 
stood to settle two days, pour off the water for use. 

Caustic Alkali, or Soap Lees. — Mix two parts of quick-lime, 
with one of pot ashes; and suffer them to stand till the lixivium be 
formed, which must be carefully filtrated through paper before it be 
83 



658 DISPENSATORY. 

used. If the solution does not happen readily, a small quantity of 
water may be added to the mixture. 

Itch Lotion. — Take of corrosive sublimate, one drachm ; crude 
sal ammoniac, two drachms; water, one pint and a half. — Mix. 

Solution of Crude Sal Ammoniac. — Dissolve half an ounce of 
crude sal ammoniac in one pint and a half of cold water, and then 
add half a pint of vinegar. 

Saturnine, or Lead -Water. — Take of sugar of lead, two drachms; 
vinegar, one ounce ; water, one pint and half. — Mix. 



WARM AND DISCUTIENT LINIMENTS. 

Opodeldoc. — Take of Castile soap, powdered, three ounces, cam- 
phor, one ounce ; brandy, one pint. Digest the soap, in the spirit 
by the fire until it be dissolved, and then add the camphor. 

Volatile Liniment. — Is made by mixing one part of spirit of harts- 
horn with two of sweet oil, good hog's lard, or fresh butter from the 
churn : they should unite into a uniform, white, soapy mixture ; and 
if they do not, it is owing to the spirit of hartshorn not being suffi- 
ciently caustic. When lard or butter is made use of, they should be 
first melted ; they may then, like the oil, be mixed with the spirit of 
hartshorn, by shaking them together in a phial. 

Camphorated Oil. — Take of camphor, half an ounce ; olive oil, 
two ounces. Moisten the camphor with a little spirit, and then rub 
it in a mortar with the oil until dissolved. 

Anodyne Liniment — Is prepared by adding half an ounce of lau- 
danum to two ounces of either of the above liniments. 

Mindererus' Spirit — Applied warm, by means of a soft flannel, 
very powerfully tends to discuss an incipient tumour, or other in- 
flammatory swellings. 

Ether — Pour about a tea-spoonful into the hollow of the hand, 
and immediately apply it over the part affected, keeping the hand on 
the part until the ether be evaporated, or as long as the patient can 
bear the heat it excites. No remedy so suddenly and effectually re- 
moves cramps and all spasmodic pains. 

Warm Plaster. — Take of the gum plaster and Burgundy pitch, 
each an ounce ; of blistering plaster, one quarter of an ounce; melt 
and mix them together. This is a most useful application whenever 



DISPENSATORY. 659 

it is required to keep up a constant perspiration, and gentle irritation 
of the skin, over any particular part affected with rheumatism, oi 
any internal pain, unattended with external inflammation. 

Charcoal Powder. — Put lumps of charcoal a second time into the 
fire until they are red hot ; then take them out, and as soon as they 
become cool, blow off the external ashes, and immediately reduce 
them to a fine powder, which must be kept in a corked bottle. 
This powder is admirable for correcting bad breath, as well as arrest- 
ing the progress of mortification. 



EYE WATER. 

Take of vinegar, one ounce ; spirits or brandy, half an ounce; rose 
or spring water, half a pint. The strength may be diminished or 
increased, according to circumstances. This is a useful application 
to weak, watery eyes, or to remove the pain and sense of pricking, 
experienced in the globes of the eyes, after they have been fatigued 
by close attention to some one object. 

Another. — Take of sugar of lead and white vitriol, each, twenty 
grains; spring water, half a pint. — Mix. After the sediment is 
formed, pour off the clear liquor, with which wash the eyes repeat- 
edly during the day, and at bed-time apply a thick fold of linen or 
cotton rag moistened with it, over the eyes. 

Another. — Take of corrosive sublimate, from two to four grains ; 
water, half a pint. — Mix. This solution may be used in general 
with great advantage in syphilitic or scrofulous cases, where the eye- 
lids have been long affected with chronic inflammation. 



ASTRINGENT WASHES. 

Take of lime-water, half a pint ; brandy, four ounces. — Mix. 

Or, lime-water, half a pint ; corrosive sublimate, fifteen grains. — 
Mix. 

Or, lime-water half a pint : tincture of myrrh, one ounce. — Mix. 

Or, make a solution, either of lunar caustic, or blue vitriol in 
water, of sufficient strength to produce a little smarting. To be ap- 
plied on lint to the sore. 

Solution of Kali. — Dissolve from one to two drachms of salt of 
tartar in half a pint of water. To be applied as above. 



660 DISPENSATORY. 



GARGLES. 

Common Gargle. — Take of barley water, or flax-seed tea, half a 
pint ; crude sal ammoniac, one drachm. — Mix. 

Or, sage tea, half a pint ; vinegar, half an ounce ; nitre, one 
drachm ; honey, one ounce. — Mix* 

Or, take of decoction of barley, one pint ; nitre, six drachms, 
honey, three ounces. — Mix. These are mild, cooling applications, 
and very serviceable at the commencement of inflammatory affec- 
tions of the tonsils and fauces. 

Gargle of Borax. — Take of borax, two drachms ; flax-seed tea, 
or mucilage of quince-seed, six ounces ; honey, one ounce. The 
borax gargle is very much in use as a mild detergent in apthous af- 
fections in children, and for removing superficial inflammatory ul- 
cerations of the gums ; especially if attended with a copious secre- 
tion of saliva. 

Linseed Gargle. — Take of flax-seed tea, twelve ounces ; honey, 
two ounces ; elixir vitriol, half a drachm. Where mild astringents 
are indicated, this gargle will be found to answer very well. 

Astringent Gargles. — Take of sage tea, or infusion of roses, half 
a pint ; vinegar and honey, each, two ounces ; alum, half a drachm. 
—Mix. 

Or, infusion of oak bark, half a pint; honey, one ounce ; alum, 
half a drachm. — Mix. 

Detergent Gargle. — Take of astringent gargle, half a pint ; tinc- 
ture of myrrh, from half an ounce to an ounce. — Mix. 

Or, take of corrosive sublimate, three grains ; dissolved in spirit of 
wine, half an ounce; and then add decoction of bark, six ounces; 
tincture of myrrh, half an ounce ; honey, one ounce. — Mix. In ve- 
nereal cases, of long standing, the tonsils and uvula, or part of the 
fauces, are found in a state of ulceration ; in which cases, besides the 
internal administration of mercury, the parts should be frequently 
washed with the above gargle. 



INJECTIONS FOR GONORRHCEA. 

Take of white vitriol and sugar of lead, each, one scruple ; muci- 
lage of gum Arabic, or common water, half a pint. — Mix, and after 
standing ten or fifteen minutes, strain ofT the clear liquor. An ordi- 
nary syringe full, to be thrown up the urethra six or eight times a- 
day, after making water. 



DISPENSATORY. 661 

Or, dissolve fifteen or twenty grains of white vitriol in half a pint 
of mucilage of gum Arabic or water. To be used as the preceding. 

Or, dissolve one grain and a half of corrosive sublimate in half a 
pint of water. To be used as above. 

Or, take of mercurial ointment, one drachm ; sweet oil, one ounce 
— Mix. This injection should be warmed previously to using. 

These injections may be made weaker or stronger, according to 
circumstances. The first and second injection are decidedly the 
best in recent cases. 

When the scalding of the urine is troublesome, four drops of mu- 
riatic acid to two ounces of water, or one part of acetated ammonia, 
to eight or ten of water, are often useful as injections. 

In obstinate cases of gonorrhoea the mercurial injections, as above, 
will be found most beneficial : and in obstinate gleets, the following 
have been employed with very happy effects. 

Injection of Tea. — Take of green tea, one drachm ; boiling water, 
six ounces; macerate in a close vessel till cold, and strain. 

Or, take of kino in powder, two drachms ; alum, one drachm ; 
mucilage of gum Arabic, one ounce ; spring water, one pound. — Mix 
and strain. 

Injection of Copaivi. — Take of balsam copaivi, one drachm ; mu- 
cilage of gum Arabic, half an ounce ; rose or spring water, six ounces. 
Rub the copaivi and mucilage well together, and add the water. 
This, as well as the preceding injection, is, perhaps, better fitted for 
females, when a discharge is kept up from a relaxed state of the 
folds of the vagina, whether arising from gonorrhoea, from too fre- 
quent coition, or from the fluor albus, or whites. 

At the commencement of gonorrhoea, the irritation is often so 
great as to occasion the greatest possible distress ; the urethra then 
being so exquisitely sensible that the slightest distension of its orifice 
or canal, even by fluids of the blandest nature, gives the most ex- 
quisite pain. The urine, in such cases, is scanty and high-coloured ; 
and whenever it is passed, aggravates all the symptoms, leaving an 
increased desire to pass more urine, attended with a burning smart- 
ing pain. The intention of cure, then, would be to lessen the in- 
flammation of the parts, by removing the distention, and of diminish- 
ing the stimulating properties of the urine. With this view, besides 
evacuating medicines and diaphoretics, particularly the camphorated 
powders and leeches, should be applied to the under part of the ure- 
thra along its whole course, and cold saturnine applications to the 
penis. 



662 DISPENSATORY. 



CLYSTERS. 



Simple and Emollient Clysters. — Milk and water in equal parts. 
Flax-seed tea. Mallow tea. Infusion of quince-seed. Barley 
water. Mucilage of gum Arabic, or slippery elm. Thin starch. 
From half a pint to a pint of either of these should be administered 
a little more than milk warm. They are useful and efficacious 
where mere relaxing and emollient effects are required ; the addition 
of the mucilaginous substance will occasion them to be longer re- 
tained than simple water would be, and are particularly proper when 
any irritation or remarkable tenderness of the intestines exists : with 
the same intention, a table-spoonful of good sweet oil, fresh hog's 
lard, or fresh butter from the churn, may be added ; but, unless per- 
fectly fresh, should be omitted, as the least rancidity will irritate and 
injure. 

Common Clyster. — Take of barley water, or flax-seed tea, from 
one to two pints ; sweet oil, two or three ounces ; Glauber or Epsom 
salts, one or two ounces. — Mix. 

Or, take of warm water, one pint or more ; molasses, one gill, or 
brown sugar two table-spoons full ; hog's lard, one spoonful, or sweet 
oil, two ounces. — Mix. This quantity is intended for adults. 

Stimulating Clyster. — Common salt and brown sugar, each two 
large table-spoons full ; hog's lard, two table-spoons full ; or olive or 
castor oil, four ounces ; water, one pint. — Mix. 

Or, take of senna, one ounce ; spring water, two pints. Boil them 
till a pint only remains; and, to the strained liquor, add common 
salt and hog's lard, each two table-spoons full. — Mix. 

Turpentine Clyster. — Take of turpentine, half an ounce; the 
yolk of an egg, flax-seed tea, or solution of gum Arabic, ten ounces. 
Rub the turpentine with the egg till they are perfectly incorporated, 
and add the linseed infusion. The turpentine injection has fre- 
quently been of service in suppression of urine, arising from a stone 
in the bladder. 

Anodyne Clyster. — A gill of new milk, or thin starch, or the 
same quantity of any of the mucilaginous substances enumerated 
under the head of Simple and Emollient Clysters, with the addition 
of one or two tea-spoonsful of laudanum, for adults. In general, a 
patient will bear three times the quantity of laudanum administered 
in this way, than would be a proper dose when taken into the sto- 
mach: so that, to procure rest, twenty-five drops would be given in 
a draught, seventy-five may be administered in a clyster, and the 
sickness, and other ill consequences, which some persons complain 
of after laudanum has been taken into the stomach, seldom follow 
when administered by clysters. 



DISPENSATORY. 663 

Nourishing Clysters. — May be formed by adding to a gill or half 
pint of beef tea, arrow-root, or gruel, twenty or thirty drops of lau- 
danum. The addition of laudanum is made to prevent the clyster 
from being rejected 



OINTMENTS. 

Simple Ointment. — Take of olive oil, five parts; white wax, two 
parts. Mix them together, by a slow fire, and stir until it be cold. 

Saturnine Ointment. — Take of sugar of lead, two drachms; 
white wax, two ounces; olive oil, half a pint. Rub the sugar of 
lead, previously powdered, with some part of the olive oil ; then add 
it to the wax melted with the remaining oil, and stir the mixture 
until it be cold. 

Basilicon Ointment. — Take of rosin and bees-wax, each, one 
pound; hog's lard, one pound and a half. Melt them together by 
a slow fire, and strain the mixture while hot. 

Turner's Cerate. — Take of calamine, prepared, yellow wax, each 
half a pound ; hog's lark, one pound. Melt the wax with the lard, 
and as soon as the mixture, exposed to the air, begins to thicken, 
mix with it the calamine, and stir the cerate until it be cold. 

Mercurial Ointment.— -Take of quicksilver, half a pound ; mut- 
ton suet, the more rancid the better, or old mercurial ointment, one 
ounce ; hog's lard, one pound. Triturate the mercury with the pre- 
pared suet and a small portion of the lard, till the globules perfectly 
disappear; after which add the remainder of the lard, and let the 
whole be intimately mixed. It is requisite that the trituration be 
constant and uniform, and continued in the first instance, till the 
globules be perfectly extinguished, and afterwards till the ointment 
be intimately mixed. If a small quantity of old mercurial ointment, 
or rancid lard, be employed, the extinction of the quicksilver is much 
more rapid and effectual. This ointment is principally employed, 
with the intention of introducing mercury in an active state into the 
circulating system, which may be affected on the sound skin of any 
part by gentle friction, particularly on the inside of the legs and 
thighs. Camphor, in the proportion of a drachm to an ounce of the 
ointment, is sometimes added, in order to render this application 
more stimulating and to promote the absorption of mercury. 

Hemorrhoidal Ointment. — Take of galls levigated, two parts; 
hog's lard, eight parts. — Mix. 

Tar Ointment. — Take of tar and mutton suet, each one pound. 
Melt them together, and strain through coarse linen. This is much 
extolled for removing tettery eruptions, and for curing scald-heads. 



664 DISPENSATORY. 

Itch Ointment. — Take of hog's lard, two ounces; sulphuric acid, 
two drachms. This ointment should be formed in a Wedge wood's 
or glass morter. It is said to be an affectual cure for the itcfe. 

Blistering Plaster. — Take of wax, rosin, tallow, and cantharides, 
each equal parts. Having melted the three first ingredients together, 
sprinkle and mix in the flies powdered a little before they become 
firm. When the blistering plaster is not at band, its place may be 
supplied by sprinkling the flies over any ointment or paste, spread 
thin, on leather or cloth. 



CATAPLASMS AND POULTICES. 

Cataplasm of Alum, commonly called Alum Curd — Is made by 
briskty agitating the whites of two eggs with a lump of alum till a 
coagulum is formed. It is useful in some cases of ophthalmia, when 
attended with a watery excretion, if applied to the eye between two 
pieces of thin linen rag. The alum curd has been found an effica- 
cious remedy applied to chilblains, previous to the skin cracking and 
becoming sore. 

Cataplasm of Mustard. — Take of good mustard and flour, or 
crumbs of bread, each, equal parts ; sharp vinegar, sufficient to form 
a poultice. It may be rendered more stimulating, if necessary, by 
the addition of a little garlic or horse-radish. 

Cataplasm of Common Salt. — Take of linseed, or Indian meal, 
and crumbs of bread, each, equal parts; saturated solution of com- 
mon salt, sufficient to make a poultice. This form of poultice has 
lately been brought into considerable repute for the reduction of in- 
dolent strumous swellings and enlargement of the glands. After 
being some time used, it generally occasions very considerable redness 
upon the surface, and excites, not unfrequently, so much inflamma- 
tion upon the part to which it is applied, that it becomes necessary 
to abstain from its use, and substitute the common white bread and 
milk poultice in its stead ; as soon, however, as the inflammation 
subsides, the saline poultice should again be employed ; and by alter- 
nating this mode of practice, strumous swellings, and scrofulous en- 
largements, of a chronic, obstinate nature, have very frequently been 
totally dispersed. 

Saturnine Poultice. — Crumbs or slices of bread are to be soaked 
in lead water, which are afterwards to be simmered in an earthen 
vessel, over a gentle fire, to a due consistence. To superficial in- 
flammations, this form of cataplasm, or making a dough of corn meal 
and lead water frequently repeated, are very beneficial. 



DISPENSATORY. 665 

Milk and Bread Poultice. — This poultice, which is generally in 
use, is commonly made by soaking crumbs or slices of bread in milk, 
and simmering them together over a gentle fire till they are reduced 
to the proper consistence of a poultice. The whole is then to be 
beat smooth with a spoon, and applied as warm as the patient's feel- 
ings will readily admit, which should be repeated every four hours. 

Flax-seed Poultice. — Take of flax-seed bruised, half a pound ; 
boiling water, half a pint, to be formed into a poultice. 

Or, This poultice may be made by stirring linseed powder into 
boiling water, in quantity sufficient to form it of a proper consistency. 

Carrot Poultice. — Boil any quantity of fresh carrots till they are 
sufficiently soft to be beat into a smooth, even pulp, which is to be 
applied as a poultice. This has been found very effectual for 
sweetening cancerous sores and foul ulcers, thereby rendering the 
condition of the patient much more comfortable. Turnips used in 
the same way have been found to produce the same effects, and ap- 
parently in a greater degree than carrots. 

Charcoal Poultice. — To a sufficient quantity of the bread and 
milk, or linseed poultice, stir in as much charcoal in fine powder as 
it will bear, and let the whole be well mixed. This cataplasm is 
often used to sweeten foul offensive ulcers and venereal sores, and 
for this purpose it is of great service; it will, likewise, often dispose 
them to assume a more favourable and healthy aspect. 



glossary; 



OR, 



EXPLANATION OF TECHNICAL TERMS. 



ABDOMEN, the belly. 

Abortion, miscarriage. 

Abscess, a tumour containing matter. 

Absorbents, medicines to correct acidity 
and absorb or dry up superfluous mois- 
ture. 

Abstemious, low living. 

decelerate, to quicken. 

Acescent, having a tendency to acidity. 

Acidulated, impregnated with acids. 

Acme, full height. 

Acrid, sharp and corrosive. 

Acute, this term is applied to a disease 
which is violent and tends to a speedy 
termination. 

Adult, of full age, beyond puberty. 

Affinity, likeness, resemblance. 

jSffudon, pouring one thing on another. 

After-birth, or placenta- cake, is the sub- 
stance by which the child is connected 
with the mother in the womb. 

After pains, see grinding pains. 

Ague-cake, enlargement of the spleen. 

Alcohol, rectified spirits of wine. 

Aliment, nourishment. 

Alimentary canal, or tube, the stomach and 
intestines. 

Alkali, any substance which mingled with 
acid, produces fermentation. 

Alternate, branches or leaves, or flowers, 
springing out regularly one above an- 
other. 

Alternate, changed by turns. 

Analogous, one like another. 

Annual, living only one year. 

Anodyne, composing medicines, and such 
as mitigate pains. 

Antidote, a medicine to destroy poisons. 

Antifogmatics, drams. 

Antipathy, an aversion to particular things. 



Antiphlogistic, counteracting inflammation. 
Antiscorbutic, good against the scurvy. 
Antiseptics, medicines to correct putridity 

or rottenness. 
Antispasmodic, whatever tends to prevent 

or to remove spasm. 
Antispasmodics, medicines for curing 

spasms, as laudanum and ether. 
Anus, the fundament. 
Aperient, opening. 
Apthous, resembling the thrush. 
Areola, the circle which surrounds the 

nipple on the breast. 
Aromatic, spicy, pungent. 
Artery, a conic canal, conveying the blood 

from the heart to all parts of the body. 
Astringents, medicines to correct looseness 

and debility. 
Atmosphere, surrounding air. 
Attenuants, medicines for reducing the 

body. 
Ataxic, irregularity of the symptoms, or of 

the animal functions. 

BIENNIAL, continuing alive for two 
years. 

Bile, or gall, a fluid secreted by the liver 
into the gall-bladder, and thence dis- 
charged into the intestines for the pur- 
pose of promoting digestion. 

Bougie, a taper body, introduced into a 
passage or sinus, to keep it open or to 
enlarge it. 

Bolus, a form of medicine in a mass, larger 
than pills. 

Bulbous root, as garlic and onion ; it is 
either, 

Solid as in the tulip and turnip, 
Scaly as in the lily, 
Coated as in the ouion. 



66S 



GLOSSARY. 



CALCULOUS, stony or gravelly. 

Callous, hard or firm. 

Cantharides, the Spanish flies, used in 

blisters. 
Capillary, fine, hair like. 
Capsule, a dry hollow vessel containing 

the seed or fruit. 
Carious, rotten, applied principally to the 

bones and teeth. 
Carminatives, medicines for dispelling 

wind. 
Cataplasm, a poultice or soft plaster. 
Catarrh, a discharge from the head or 

throat. 
Cathartic, a purge. 
Catheter, a pipe to draw off urine. 
Catkin, a composition of flowers and chuff 

on a long slender thread shaped recepta- 
cle, the figure of the whole resembling 

a cat's tail. 
Caustics, burning applications. 
Cautery, the act of burning with a hot iron 

or caustic. 
Cutaneous, of or belonging to the skin. 
Characteristic, a mark, sign, or token. 
Charcoal, a coal made by burning wood 

under turf. 
Chronic, lingering disease, in opposition 

to acute. 
Chyle, a milky fluid separated from the 

aliment in the intestines, mixing with 

and forming the blood. 
Circulation, the motion of the blood, which 

is propelled by the heart through the 

arteries, and returned by the veins. 
Clammy sweats, cold glutinous. 
Cleansi?ig, see lochial discharge. 
Coagulum, a curd. 
Comatose, inclined to sleep. 
Compress, several folds of linen rags, a 

bandage. 
Concave, hollowed out like a bowl, as the 

petals of the cherry or the hawthorn ; 

and the broad-leafed plantain. 
Cone, or strobile, a species of seed vessel 

formed by a catkin with hardened scale ; 

containing a seed within the base of 

each scale ; as in the pine or fir. 
Confluent, running together. 
Constipation, obstruction, costiveness. 
Contagion, infectious matter. 
Contusion, a bruise. 
Convalescence, recovery from sickness. 
Convex, opposed to concave : rising like 

the surface of a globe. 
Convulsions, violent motions, fits. 
Corolla, blossoms, petals, or flower-leaves, 

is that beautiful part of a flower which 

first draws the attention, as the flower 

itself. 
Corroborants, tonics, or strengthening me- 
dicines. 
Corrosive, substances that consume or eat 

away. 
Cortex, bark, or covering. 



Cosmetic, beautifying. 

Crisis, a certain period in a disease at 
which there happens a decisive altera- 
tion, either for the better or worse. 

Critical, decisive or important. 

Crudity, rawness, indigestion. 

DEBILITY, weakness. 
Decoction, a preparation by boiling. 
Decumbent, lying down or declining. 
Deglutition, the act of swallowing. 
Deleterious, poisonous, deadly. 
Delirium, light-headedness. 
Demoniacal, baneful, hurtful. 
Demulcent, softening, sheathing. 
Dentition, teething. 
Detergent, cleansing. 
Diaphoretic, promoting perspiration. 
Diarrhoza, a looseness. 
Diathesis, disposition or habit of body. 
Dietetic, relating to diet, or regimen. 
Diluents, substances to dilute or make thin. 
Discutient, a medicine that has the power 

to repel. 
Dislocation, a joint put out of place. 
Disposition, tendency. 
Diuretic, whatever promotes the secretion 

of urine. 
Drastics, active or strong purges. 
Dyspeptic, belonging to bad digestion. 

ECCHYMOS1S, a tumour, the effect of 
blood-letting. 

Efflorescence, eruption, or the redness 
round it. 

Effluvia, exhalation. 

Egg-shaped, signifies a shape resembling 
the solid substance of an egg; or, in re- 
spect to leaves, it implies only the form 
of an egg, divided lengthwise. 

Emaciation, wasting of flesh. 

Empiric, a quack. 

Enamel, the outside covering of the teeth. 

Endemic, a disease peculiar to a certain 
district. 

Enervate, to weaken. 

Epidemic, contagious. 

Equilibrium, equal in weight. 

Eructation, a belch. 

Eruption, breaking out in pustules. 

Exacerbation, the increase of a disease. 

Excoriation, the loss of the skin. 

Excretion, discharge of animal fluids, or 
matter. 

Exhibit, to administer. 

Expectoration, a discharge from the breast. 

Extremities, arms and legs. 

FJECES, excrements. 
Farinaceous, mealy. 
Febrifuge, removing fever. 
Febrile, feverish. 
Fetid, of an offensive smell. 
Fibrous, composed of small threads or 
fibres. 



GLOSSARY. 



660 



First passages, stomach and bowels. 
Flatulent, producing wind. 
Flooding, an overflow of the menses. 
Fcetus, the child in the womb. 
Fomentation, partial bathing, by the appli- 
cation of flannels dipped in liquids. 
Fracture, a broken bone. 
Friction, the act of rubbing. 
Fungus, proud flesh. 
Fumigation, a vapour raised by burning. 

GANGRENE, a feeble circulation, fol- 
lowed by mortification. 

Gargle, a wash for the mouth and throat. 

Germen, or seed-bud, the lower part of a 
pistil, is destined to contain the embryo 
seed. 

Genus, the second subdivision of plants ; it 
comprehends an assemblage of species 
under the same class and order. 

Gland, a secretory organ. 

Glutinous, .gluey, sticky. 

Grinding, or after-pains : pains that occur 
after labour. 

Grog-blossoms, pimples on the face pro- 
duced by drinking. 

HEART-SHAPED, a term used to ex- 
press the form of a petal or leaf which 
resembles a heart divided lengthwise. 

Hectic fever, a slow consuming fever gene- 
rally attending the absorption of puru- 
lent, or other acrid matter into the blood. 

Hemorrhage, a discharge of blood. 

Hemorrhoidal, relating to the piles. 

Hepatic, relating to the liver. 

Hypochondriacal, melancholy, very deject- 
ed, low T in spirits. 

ICHOR, a thin watery humour. 

Imbecility, debility, weakness. 

Immersion, plunging under water. 

Imposthume, a collection of purulent matter. 

Inanition, emptiness. 

Incarnating, healing. 

Incrassate, to thicken. 

Indented, the edges of an indented leaf are 
hollowed, or deeply scolloped, the lobes 
standing asunder, as if part of the leaf 
had been cut out. The leaves of the oak 
and turnip are familiar examples. 

Indigenoxis, native to a country. 

Indigestible, difficult of digestion. 

Induration, hardening. 

Indisposition, a disorder of health. 

Inebriety, drunkenness. 

Infection, contagion. 

InJIammation, an increased action in a part. 

Inflated, distended, as if inflated like a 
blown up bladder. 

Infusion, steeping any thing in liquor with- 
out boiling, as tea is made. 

Inhale, to draw in by breath. 

Inspissate, to thicken. 



Intestinal, belonging to the intestines, or 

guts. 
Intestines, the internal parts of the body. 
Irrespirable, unfit to be breathed. 
Irritability, a disposition to contract from 

a stimulus. 
Juleps, mixtures, of simple and compound 

mixtures. 

LACTEALS, vessels containing chyle 
Languor, want of strength or spirits. 
Lateral, growing 1'rom the sides of the 

stems or stalks. 
Laxatives, relieving costiveness. 
Levigated, reduced to a fine powder. 
Ligature, a bandage ; any thing tied round 

another. 
Ligneous, woody. 
Liniment, a composition of the consistence 

of oil. 
Lobed, divided, or lip-shaped. 
Lotion, a wash. 
Lochial discharge, or cleansings, a discharge 

from the womb. 

MAGNUM DEI DONUM, the great gift 

of God. 
Mastication, act of chewing. 
Maturity, of full years. 
Meconium, the infant's first or black stools. 
Membrane, a web of fibres, interwoven, 

for covering certain parts. 
Menses, > ,, ,, . 

Menstruation, \ the monthl y courses 
Mephitic, suffocating, noxious. 
Meum et tuum, mine and thine. 
Miasmata, > , . , , , ,. 
Miasma \ mox " l & exhalation, or vapours. 

Miliary eruption, an eruption of pustules 
resembling the seeds of millet. 

Modus operandi, mode of operation. 

Morbid, diseased, corrupt. 

Mucilage, a glutinous, slimy substance. 

Mucus, resembling the matter discharged 
from the nose, lungs, &.c. 

NARCOTICS, medicines producing tor- 
por and sleep. 

Nausea, an inclination to vomit. 

Nervous, irritable. 

Nostrum, a patent or other medicine, the 
composition of which is kept secret by 
the proprietor. 

OBLONG, considerably longer than 
broad, and narrowed, though rounded at 
the ends ; as the leaves of the daisy. 

Qbtund, to blunt. 

CEdematous, swelled, as in a dropsical 
state of the skin. 

Opiates, medicines which promote sleep, 
as opium. 

Ophthalmia, a disease of the eyes. 

Ovate, or oval, egg-shaped. 



C70 



GLOSSARY. 



PANCREAS, the sweet bread. 

Paralytic, relating to palsy. 

Paroxysms, a periodical fit or attack. 

Pectoral, medicines adapted to cure dis- 
eases of the breast. 

Pedical, a short foot stalk, or partial foot- 
stalk, being that part of a compound or 
branched fruit-stalk, which is the imme- 
diate support of a single flower, or floret. 

Pelvis, the bones at the lower part of the 
trunk of the body. 

Perennial, continuing for several years ; at 
least more than two, and regerminating 
several years successively. 

Pestilential, infectious. 

Petals, the leaves which constitute the 
blossoms or flowers are so called to dis- 
tinguish them from the other leaves of 
the plant. 

Phlegmatic, relaxed and abounding with 
phlegm. 

Phlogistic, inflammatory. 

Phthisical, consumptive. 

Pilch, napkin, clout. 

Placenta- cake. See after-birth. 

Plethoric, of a full habit. 

Plenitude, fulness of blood. 

Precarious, doubtful, uncertain. 

Predisposition, susceptibility of disease. 

Premature, too hasty, too early. 

Preternatural, unusual, not natural. 

Primary, original. 

Prolapsus, the falling down or out. 

Proximate cause, the immediate cause of 
disease. 

Ptyalism, a copious flow of spittle. 

Puerperal, of, or belonging to, child-bed. 

Pulmonary, belonging to the lungs. 

Purulent, matter of good quality. 

Pus, matter. 

Pustule, a purple or small swelling. 

Putrescence, rottenness. 

QUARTAN, returning every fourth day. 
Quickening, the motion of the child felt by 
the mother in the womb. 

RECTUM, the strait gut in which the 
faeces are contained. 

Red gum, an eruption so called. 

Refrigeration, a. chill, coldness. 

Regimen, regulation of food, air, exercise, 
&c. 

Remote cause, the inducing cause of disease. 

Repletion, the act of filling the body with 
food. 

Resolution, a termination without suppu- 
ration. 

Resolvents, dissolving medicines. 

Respiration, the act of breathing. 

Resuscitation, reviving, bringing to life. 

Retention, the retaining of some natural 
discharge. 

Rheumy, an acrid discharge. 



SALINE, consisting of salt. 

Saliva, spittle. 

Sanative, healing. 

Sanguiferous, carrying blood. 

Saponaceous, soapy. 

Saturnine lotion, lead water. 

Scorbutic, of, or belonging to, scurvy 

Scrofulous, of, or belonging to, the king's 
evil. 

Secondary, not primary ; a secondary fever 
is that which occurs after crisis. 

Secretion, the separation of fluids from the 
body. 

Secundines, the placenta, and membranes. 

Sedatives, composing medicines. 

Segments, the small part of a leaf, cup, or 
petal, included between the incision. 

Semen, the seed. 

Serous, thin, watery. 

Serrated, notched like a saw. 

Sinapism, a poultice made of flour, mus- 
tard, and vinegar. 

Slough, the parts that separate from a sore. 

Solitary, only one in a place ; as but one 
flower on a fruit stalk, or only one fruit- 
stalk proceeding from the same part of a 
plant. 

Soluble, loose, laxative. 

Spasm, cramp, convulsion. 

Specific, an infallible remedy. 

Spear-shaped, applied to a leaf, signifies 
that it is shaped like a spear or lance. 

Spherical, globular. 

Spike, a head or ear, as in rye, barley, 
wheat, &c. 

Spine, the back-bone. 

Stamina, the constitution or habit of the 
body. 

Stimulants, irritative medicines. 

Stomachics, medicines for the stomach. 

Strangury, a difficulty of making water. 

Striated, channelled, furrowed. 

Stupor, a suspension of sensibility. 

Styptic, a medicine stopping the discharge 
of blood. 

Sudorifics, medicines to promote sweating. 

Suppository, a candle, or any other sub- 
stance or composition, introduced into 
the rectum to produce a stool. 

Swooning, fainting. 

Symptomatic, a disease not primary, but 
arising from another in contradistinction 
to idiophatic. 

Syncope, a fainting or swooning. 

Synocha, inflammatory fever. 

TECHNICAL, belonging to arts. 

Temperament, a peculiar habit of body. 

Temperature, state of the air. 

Tertian, returning every third day. 

Tetany, the lock-jaw. 

Tonic, bracing, strengthening. 

Topical, local, confined to the diseased part. 

Tumour, a swelling. 



GLOSSARY. 



671 



Turgescence, an over fulness. 
Type, a mark. 

Typhus, a genus of fever comprehending 
those called nervous, yellow, and putrid. 

ULCER, a sore, generally ill-conditioned. 

Umbel, a composition of flowers, in which 
a number of slender fruit-stalks proceeds 
from the same centre, and rise nearly to 
the same height, so as to form a regular 
surface at the top. Hemlock, carrot, 
and low parsnip, are examples. These 
are said to be umbelliferous plants. 

Umbilical cord, the navel string. 

Urethra, the canal which conveys the urine. 

Uterine, belonging to the womb. 

Uterus, the womb. 

Uvula, the palate. 

VACCINE, vaccinous, belonging to, or 

matter of the cow-pox. 
Vagina, the passage to the womb. 
Valetudinarian, a weak, sickly person. 



Variolus, small-pox matter. 
Vascular, belonging to the vessels. 
Vehicle, a liquor to make medicines in. 
Venous, belonging to the veins. 
Ventilation, a free admission or motion of 
air. 

Venomous, } 

Virulent, I? 01 * ™™- 

Vermifuge, worm-dispelling medicines. 

Vertigo, giddiness. 

Vesicating, blistering. 

Villous, shaggy, rough, hairy. 

Virous, poisonous matter. 

Viscera, the entrails. 

Viscid, glutinous, tenacious. 

Vital, the seat of life. 

WHITES, the discharge from the womb 
Whorls, this term is applied either to 
branches, leaves or flowers, when they 
grow all round their respective stems, 
resembling, in some measure, the spokes 
round the nave of a wheel. 



INDEX 



A. 



Page 

52 



ABDOMEN, description of 
Abdominal Supporter of Mr. 
Betts, highly useful in cases 
of prolapsus uteri and pro- 
trusion of the vagina, . 457 
Abortion, observations on 424, 425 

prevention of . 426 

Abscess, common . . . 350 
Absorbents, class of . . 640 

mixture, doses of 633 

how prepared 640 

Abstemious living, good effects 

of 79, 80 

Acid, nitric, tonic, . . 654, 655 
muriatic, useful in nerv- 



ous fever, 

— vegetable antiscorbutic 



191 
331 

Acute rheumatism, . . . 254 
Acidity, or heartburn, . 299, 417 
Adams, John, his death and 

character noticed . . 284 
Admonitory hints to ladies, 395 
Advice to masters, . . . 33 

to parents, . . . 476 

Adulterated wines, to de- 
tect 600, 601 

After pains, 443 

After birth, caution respecting 433 

mode of extracting, 439 

Agaric, stops bleeding, . 518 
Agrimony, useful in jaundice, 518 
Ague and fever, .... 164 
Air, its influence on the blood, 65 

on the body, ... 66 

85 



Pags 

Air, necessity for its renew- 
al, ....... 68, 72 

confined, bad effects of 69 

warm, relaxes the body, 74 

damp, checks perspiration, 74 

— — the most wholesome, 74 

impure, how restored, 

....... 75, 198, 199 

Air and temperature, how to 

be regulated in sickness, 610 
Alder, black, antiseptic, . 519 
Aloetic pills, how prepared 637 
Alteratives, class of . . 655 
Alterative diet drink . . 655 
Alum, doses of ... . 62S 

curd, how prepared 664 

whey, how prepared, 625 

root, useful in cancers, 519 

Alvine discharge, nature of 211 
Americans, patriotism of . 149 
Anatomical description of the 
human body, concise and 
interesting, .... 36 

Anasarcous swellings, . . 317 
Ankle, dislocation of . . 364 



Angelica, good aromatic, 



519 



Anger, its ill effects on mind 
and body 116; melancholy, 
instances of 118; advantages 
of repressing 118; wonder- 
ful effects of music in sub- 
duing 118, 119 

Animation suspended, how re- 
stored, 340, 4b? 

Animal heat depends on the 
circulation of the blood, 51 



674 



INDEX. 



Page 

Animal heat, depression of, 

how to be restored, 177, 194 
Anodynes, class of, . . 645 
Anodyne liniment, to prepare, 658 

sudorific drops, doses 

of, 633 

how prepared, 640 

Anti-bilious pills, how prepar- 
ed, 636 

Anti-dysenteric mixture, 633, 650 
Antimonial wine, doses of 628 

— - how prepared, . 657 

powders and solution, 639 

Antiphon promised to do upon 
souls what Hippocrates did 

on bodies Ill 

Antipathy to certain remedies, 

consequences of . . . 29, 615 
Anus, imperforated . . 483 

falling down of . . 349 

Aperient medicines, import- 
ance of in fevers, . 176, 635 
Aperient and diaphoretic pills, 635 
Apoplexy, or apopletic fits 284 
Appetites, three kinds of 77, 617 
Apparent death, to resuscitate 339 
Apparel, observations on 143 

Apple, Peru, a valuable plant 520 

Apple water, 626 

Apthae, or thrush . . . 489 
Arbutus, useful in gravel . 520 
Ardent spirits, utility of . 82 

■ abuse of de- 
structive to body and soul 

128, 129 

Aristides, his goodness . 125 
Arms, description of . . 37 

dislocation of . . 363 

fracture of . . . 367 

Armstrong, Dr., remarks on 

use of stimulants in fevers, 193 
Arria, her invincible love 97 

Arrow root, very nutritious 520 
Arsenic solution, doses of 628 

how prepared . . 657 

Art of preserving health . 64 
Arteries, their use explained 39 
Asarabacca, useful in whoop- 
ing-cough 520 

Ascarides, worm . . . 462 
Ascites, or dropsy of belly 316 



Page 

Askew, his singular recovery 108 
Asthma, treatment of . . 298 
Astorgas dines on the heart of 

his mistress .... 103 

Astringents, class of . . 650 
Astringent mixture . . . 650 

gargles and washes 660 

Atheist, conversion of . . 34 

— — — ■ punishment of . 158 
Athenians, religious instruc- 
tions of the .... 160 
Atmosphere, component parts 

of 67 

Avarice, injurious to health 125 

fatal instances of 126 

Hippocrates' advice 126 

Avens, antiseptic . . . 520 
Azote, or corrupted air . 67 



B. 



BACK-BONE, use of . 36 

Backache-brake, for cough 521 
Baker, Professor, praise due 518 
Balm, useful in fevers . 521 
Balsamic medicines in consump- 
tions, when useful, . . 272 
Balsam, copaiva, doses . 628 

remedy for gonorrhoea 322 

Turlington's, how pre- 
pared 656 

Barberry, useful in dysentery 521 
Bark, Peruvian, caution in the 

use of 166 

jacket, how prepared 166 

Peruvian, substitutes for 
in bilious fever . . . 181 

cold infusion of . 652 

decoction of . . 652 

tincture of ... 656 

Barley-water, how prepared 620 
Barrenness, observations on 464 
Barton, Professor, his noble ef- 
forts to serve his fellow citi- 
zens 518 

his unbounded liberal- 
ity 19 

asserts the efficacy of 



oak bark in gangrene, 565; 
of poke weed in rheumatism, 
572; of thorn apple in epi- 



INDEX. 



675 



Page 

lepsy, &c, 586 ; of tobacco 

to dislodge worms . . 590 

Bastard ipecacuanha . . 521 

Bashfulness, evidence of virtue 140 

Bath, cold, when proper . 32 

warm, efficacy of . 32, 43 

regulation of . . . 202 

Bayous, agency of in producing 

malignant fever . . . 392 
Bayberry, useful in jaundice 521 
Bearberry, useful in gravel 521 
Beaufort, his dread of death 114 
Beauty, wonderful effects of 395 
Beaumont Dr., his experiments 
on digestion made in the case 
of St. Martin, who was woun- 
ded in the side ... 83 
Bearing down of the womb 455 
Bed-room, observations on 75 
Beech drops, useful in cancers 521 
Beef tea, how prepared . 623 
Beer, recipes for ... 550 
Beggar, anecdote of . . 88 
Benne, useful in dysentery, and 

yields a good salad oil . 521 
Bethroot, useful in hemorrhages 522 
Bigelow, Professor, honourable 
mention of .... 518 

testifies to the virtues 

ofgillenia 544 

Bile, the manner in which it is 

secreted, and use of . 56 
Bilious fever, treatment of 172 
its fatality in Wash- 
ington 175 

prevention of 182 

Bind weed, purgative . . 522 
Byrd, Colonel, celebrates the 

bastard ipecacuanha . 553 
Bites of moschetoes . . 342 

of venomous animals 343 

of mad dogs . . 344 

Bitters, how prepared, . 657 

dangerous effects of 31 

Bitter sweet, good for cutaneous 

disorders, &c. . . . 522 
Blackberry, remedy in dysente- 
ry 522 

Black snake-root, useful in fe- 
vers 603 

Bladder, description of . 57 



Page 



Bladder, distended, cause 

retroverted womb 
inflammation of 



of 



Bleeding at the nose . 
Bleeding piles . . . 

from wounds 

topical 



370, 



418 
249 
267 
279 
356 
615 



Blistering plaster, how prepared 664 

Blistering plaster, substitutes for 

(See crowfoot, cuckoo-pint, 

mezereon, garlic, horse-radish.) 

Blood, circulation of . . 50 

, how it is recruited 55 

, spitting of . . 268 

Blood-letting, how performed 369 
Blood-letting, rules to be ob- 
served . . . 186, 200, 451 
Blood root, cure for polypus 522 
Blood wort, checks bleeding 523 

Bloody flux 281 

Blossoms, grog, cure of . 332 
Blotches, or eruptions . 332-487 
Boerhaave, Dr., verifies that re- 
ligion conduces to health 157 



his singular mode 



of treating epilepsy . 115 
Boils or tumours . . . 350 
Bolea, captain, his singular mode 

of taking revenge . . 122 
Bonaventure, his admiration of 

a beautiful woman . . 103 
Bones of the human machine, 

description of 37 
Boneset, remedy in agues 524 
Bowman's-root, good emetic 524 
Box-wood, excellent tonic 
Brain, seat of .... 
inflammation of 



Breasts, anatomy of . . 

swelling of, infants 

cancer of . . . 



524 
44 

228 
48 
479 
352 
622 



Bread soup, how prepared 

pudding, how pre- 
pared 623, 624 

Breath, how to preserve its 
sweetness 253 

Breeding sickness . . . 417 

Bronchitis 212 

and croup sometimes 

confounded .... "2 12 

Broomrape, useful in cancers 524 



676 



INDEX. 



Page 

Brown, Professor, his remedy 

for tetanus .... 295 
Buboes, management of . 328 
Buckthorn, good purgative 524 
Burch, captain, cured of abscess 

of liver by onions . . 566 
Burdock, purines blood . 525 
Burleigh, Lord, his just remark 

on religion .... 160 
Burnet saxifrage, useful in asth- 
ma 525 

Burns or scalds . . . 346 
Butterfly weed, remedy, in cold 

and pleurisy .... 525 
Butternut, excellent cathartic 525 
Button snake-root, useful in 
gangrene 525 



C. 



Caldwell, Professor, the manner 
he preserved the health of his 

son 75 

- remarks on worms 498 

— deserves high esteem 578 

Calico tree, remedy for itch 526 
Calimus, good aromatic . 526 
Calomel, doses of . ... 629 
Calves' feet jelly, how made 621 

broth, how made 623 

Camomile, stomachic . . 526 
Camphorated powders, doses 633 

how prepared 639 

— mixture. . 648 

liniment . . 658 

spirits . . 657 

Cancer, treatment of . . 352 

of the womb . . 459 

Cancer root, astringent . 527 
Candleberry myrtle, emetic 527 
Caraway, excellent aromatic 527 
Carrol, Mrs., cured of bilious 

fever by porter . . . 174 
Carrol, Charles, his death and 

character 245 

Carbonic acid, or fixed air 68 

Carrot, wild, diuretic . . 527 

poultices how prepared 665 

corrects fetid ulcers 527 

Cartwright, Dr., thanks due to 



him for his essays on malig- 
nant fever 373 

Cartwright, Dr. his manner of 
administering doses of medi- 
cine to his patients . . 393 
Cartilages, description of 38 

Castor oil, doses of . . 629 

how made . . 527 

Cataplasm, of mustard . 664 

of common salt 664 

of alum . . 664 

Catarrh, or cold . . . 212 
Cat gut, or goat's rue, remedy 

for worms 527 

Cathartics, class of . 635 
Cathartic mixture, doses of 633 
how prepared . 636 



Catheter, manner of introdu- 
cing. 279 

Caustic alkali, doses of . 629 

how prepared . 657 

Caution to parents . . 476 
to masters . . 33 



Celandine, useful in cutaneous 

affections 527 

Cellular membrane, use of 43 

Centaury, good stomachic 528 
Chalk, prepared, doses of 629 

Chapman, Professor, his great 
zeal in diffusing knowledge 518 

treatment of epidemic 238 

attests the efficacy of 



seneca in obstructions of the 
menses 603, and of balsam co- 
paivi, in gonorrhoea . . 323 

Chancres 328 

Chalybeate wine, how prep. 654 
Charcoal powder, how prep. 659 

— poultice, how made 665 

Chanty, godlike act . . 608 
Charlemagne, nobleness of 97 
Cheerfulness consistent with re- 
ligion 154 

Cherry tree, wild, substitute for 

Peruvian bark . . . 528 
Cheselden, Dr., on anatomy 37 
Cheyne, Dr., his mode of treat- 
ing delirium .... 613 
Chesterfield, Lord, on dress 143 
Chicken pox . . . . 265 
Chicken water, how made 623 



INDEX. 



677 



Page 

Chickweed, red, remedy for hy- 
drophobia 528 

Chilblains . . _ . 346 

Child, position of in the womb 414 
Child-bed, diseases of . 466 

management of 440 

Children, management of 442 

Chills, how a return may be 

counteracted .... 170 
Chills and fevers, vulgar mode 

of treating . . . , 
Chin, or whooping cough 
Chlorosis, or green sickne 
Chocolate, properties of . 
Cholera infantum, . . . 
morbus .... 



610 
503 
403 
83 
495 
304 

— epidemic or malignant 305 

Chordee 322 

Chorea, or St. Vitus's dance 504 
Chremes, story of, a lesson to 

the intemperate ... 78 

Christian, his consolation 111 

Chronothermal system, account 

of 514 

Chyle, how conveyed . . 55 
Cider, when wholesome . 82 
Cinquefoil, used in bowel com- 
plaints 528 

Circulation of the blood, how 

performed 49 

Clap, or gonorrhoea . . 321 
Cleanliness promotes health and 
preserves beauty . . 145 

, its importance in 

sickness . . . 33, 471, 611 
Cleavers, good for the gravel 529 
Clinias, calmed by music 118 

Clothing of infants ... 468 
Cloruret of lime used with suc- 
cess in the cure of sore eyes 

in infants 239 

Club-foot, management of 482 
Clysters, or glysters, . . 662 
Cocum, used in rheumatism 529 
Cock-up-hat, useful in yaws 529 
Coffee, properties of . . 83 

Cohush, for rheumatism . 529 
Cold, or catarrh ... 212 

remarks on the popular 

remedies 213 

of foot bathing . . 213 



Page 

Cold, of cold drinks . . 213 

of full vomiting . . 215 

of steaming the head 216 

inhaling vapour of hot wa- 
ter 218 

prevention of . . 220 

importance of avoiding the 

exciting causes . . . 229 

exposure to intense 89, 221 

Coldness of the extremities in 

fevers . . . 177, 194, 202 
Cold water, its operation upon 
the stomach .... 213 

, the impression it 

makes when externally ap- 
plied ...... 213 

Cold bath when beneficial 32 

Cold washing of infants . 471 
Cold plague, its fatality, letter 
respecting .... 372 

Colliquative sweats . . 274 
Colic, treatment of . . . 302 
Colic pains, in children . 492 
Collection and preservation of 

vegetable substances . 606 
Colts-foot, useful in coughs 529 
Columbo, American, good tonic 529 
Comfrey, astringent . . 530 
Common ulcers . . . 353 
Conception, signs of -. . 412 
Conscience, the effects of, &c. 113 



Congestion, signs of . , 
Conclusion and general re- 
marks 

Contagion how to be arrested 
Consumption .... 
use 



176 

618 
198 
269 



of 



refrigera- 
ting medicines in . . 271 

of balsamic do. 272 

of inhalation and 

273 
of sedatives 
of exercise 



fumigation 



274 



Convulsions in children 

in pregnancy 

in labour . 

hysterical 



Corday, Charlotte, interesting 

history of 

Cordial mixture .... 
Coriander, good aromatic 



27 b 

492 
421 
438 

288 

138 
647 
530 



678 



INDEX. 



Page 

Cornaro, by temperance re- 
stores a constitution im- 
paired by dissipation 79 
Corns, treatment of . . 349 
Cosmetics, observations on 396 
Costiveness, remarks on 301 

— dangerous effects 

of, in pregnancy . . 415 

■ of infants . 491 

Cough, management of . 223 

■ symptomatic . . 223 

danger of using patent 

medicines in ... . 225 
remedies recommend- 



ed 225, 226 

mixture, how prepared 644 



of the legs .. 
colic . 



Countenance, prognostic of 

disease 205 

Cow parsnip, useful in epilepsy 530 

Cow pox, or vaccine disease 258 

Cox, Professor, praise due to 518 
Craik, Dr. and Mrs., their 

death and character . 569 

Crane's bill powerful styptic 530 

Cramp, or tetances . . 293 

— in pregnancy . . 421 

of the stomach . 293 

. . 294 
. . 302 
Crawford, Wm. H. Hon., tes- 
tifies to the efficacy of on- 
ions in croup .... 566 
Crawford, Dr., his treatment 

of a hypochondriac . . 293 
Cream of tartar, doses of 629 
Cross-wort, useful in fevers 532 
Croup and Bronchetis some- 
times taken for the same 212 
Croup or hives .... 500 
Crow-foot, excites blisters 532 
Cruelty, instances of . . 117 
Cuckold, useful in jaundice 532 
Cuckow pint, used externally 

for blistering .... 532 
Cucumber-root, useful in drop- 
sies 532 

Cullen, Dr., celebrates horse- 
radish in hoarseness . 552 
Cupping, how performed . 370 
Cure-all, excellent tonic . 532 
Currant wine, how to make 532 



Page 

Currie, Dr., his improvement 
in the treatment of nervous 
fever 189 

Custard apple, a good purga- 
tive 533 

pudding how made 624 

Cutaneous eruptions . . 331 

Cutbush, Dr., his successful 
practice in the epidemic, 
bears testimony of the effi- 
cacy of acids in scurvey, 
555; of tobacco in dropsy 591 

Cutler, Hew Dr., deserving high 
commendations . . . 518 

testifies to the 



efficacy of emetic weed and 
skunk cabbage in asthma, 

536, 582 

D. 

Dandelion, useful in visceral 

obstructions ..... 533 
Darwin, Dr., gives an account 
of a parsimonious surgeon 
killing himself ... 113 
Darwin, Dr., cites a case in 
which pride was effectually 

cured 136 

his remedy to cor- 
rect bad breath, . . . 253 
Davidge, Professor, his remedy 

for croup 501 

Daviess, Colonel, his dying 

words 150 

Deadly night-shade, useful in 

rheumatism, .... 563 
Deafness, treatment of . 251 
Death overmuch fearedby some 112 
Deerberry, useful in asthma 533 
Delirium treatment of . 452, 612 
Delivery, or child-birth . 438 
Denman, Dr., his mode of pre- 
venting convulsions. . 423 
■ — — — ■ his remarks on 

preternatural labour . . 436 
Dentition, or teething . 494 
Detergent gargles . . . 660 
Devil's bit, vermifuge, &c. 533 

Dewberry, useful in dysentery 533 



INDEX. 



679 



Page 

Dewees treatment in immode- 
rate flow of the menses 406 
in sexual weak- 
ness 412 

Dexter, Prof, entitled to praise 518 
Diabetes, or incontinence of 

urine, 276 

Diaphragm, use of, . . 52 

Digestion 83 

— extraordinary case 

of St. Martin .... 83 

an opportunity of 

seeing what was going on in 

the stomach of St. Martin 84 

Diaphoretics, class of, . . 638 

— drops, . 628, 638 

Diarrhoea, or looseness, . 313 

Diet, for a healthy state, . 83 

recommended in bilious 

fever 182 

for the sick, . . 619 

■ mode of preparing, . 619 

Difficulty of urine, . . 276,418 
Digestion, how performed, 52, 54 
Dill, good aromatic, . . 533 
Directions for preserving vege- 
table substances . . . 606 
Diseases of pregnancy . 417 

■ —of childbed . . 442 

— - prognostics of . 204 

Dislocations, observations on 362 

Dislocation of the jaw . 363 

— : of the shoulder, 363 

of the elbow, 364 

■ of the wrist or finger364 

of the thigh 364 

Dislocation of the knees and 

ankles ...... 364 

Dispensatory .... 627 

Dispositions of children, how 

to be managed . . . 474 

Diuretics, class of . . , 641 

Diuretic infusion and pills 642 

Dock water, purifies the blood 533 
Dog-wood, best substitute for 

the Peruvian bark . . 534 
Domestic remedies for whoop- 
ing cough 614 

for rheu- 
matism 657 



Page 

Dorsey, Professor, his remedy 
for sore eyes .... 237 

— - notice of his death and 

character 230 

Doses of medicines, table of 628 
Dover's powders, how prepared 639 

. — — , — . doses of 634 

Dragon's claw, useful in fevers 534 
Dragon's root, used for blisters 534 
Drastic purges .... 636 

Dressing of infants . . . 468 
Dress, love of, natural . . 141 

— — neglect of, improper 143 
— — advantages of wearing 
flannel ...... 144 

Dropsy of the belly . . . 316 
— of the cellular mem- 
brane, or anarsarcae . . 317 

— of the head . . 490 

— - of the ovarium . 461 

■ of the fallopian tubes 462 

Drowned persons how to be 
treated ...... 340 

Drunkards, reclaimed, in- 
stances of 131 

— — — - ludicrous descrip- 
tion of 339 

Drunkenness, its horrid conse- 
quences 130 

Dysentery, treatment of = 281 

E. 



Ear, description of . . . 

noise in, prognostic of 

disease ..... 

Ear-ache 

Esaymosis . 
Effervescing draught . 
Egg soup, how made . 
Eginardus, anecdote of 
Elder, common, aperient. 
— wine, how made 



Elecampane, expectorant 
Elegy on the death of Col. 
Jesse Ewell .... 

on a deluded girl . 

Elixir paragoric, doses of 

how prepared 



Elixir vitriol, doses of 



45 

208 
251 
370 
63S 
622 
96 
534 
535 
535 

315 
327 
630 

656 
629 



680 



INDEX 



Page 

Elm, American, remedy in 

dysentery 535 

Emetic weed, excellent emetic 

and remedy for asthma 535 
Emetics, rules for their exhibi- 
tion 635 

Emissions, involuntary . 325 
Empirics, cause of increase 28 

cures on which their 

fame is built .... 29 

Enthusiasm, source of delusion 152 
Envy, nature of ... . 123 

— baneful effects of . 124 

antidote against . 125 

Epicurus, his dread of death 113 
Epidemic, or typhoid pneu- 
monia 226 

Epilepsy, or epileptic fits 285 

Epispastics 383 

Ergot, hastens delivery . 539 

Eructations 300 

Eruptions of the skin 331, 453, 486 
Erysipelas, or St. Anthonv's 

fire 267, 524 

Ether, vitriolic, doses of . 629 
Essence of peppermint, doses 
of ...... • 629 

Evacuations, importance of 94 
alvine, prognos- 
tic of diseases . . . 211 
Evergreen, diuretic . . 538 
Ewell, James, Dr. memoir of xv 
Excretory vessels, use of . 40 
Excoriations, or galling . 480 
Exercise, promotes health 87 

absolute necessity of 88 

mode of prescrib- 
ing, in sickness ... 651 
Expectorants, rules for their 

exhibition 643 

Eye, description of . . 44 

inflammation of . . 237 

Eye-water, how prepared 659 

F. 

Face, painful affection of 256 

Faintingfits 286 

in pregnant and ly- 
ing-in women . . 418, 439 



Page 

Falling of the fundament 349 

of the palate . . 235 

of the navel strings 438 

of the womb . . 455 

Fallopian tubes, their use 58 

False conception . . . 460 

pains . . . . . 420 

Fanaticism, dangerous conse- 
quences of .... 151 
Fashion, its excess disgusting 141 
Fear, its origin . . , . 112 

turns the hair gray . 113 

produces insanity . 113 

Fear, superstitious foundation 

of 115, 475 

Feather beds, necessity of airing 93 
Febrifuge mixture and pow- 
ders . . . . . 634, 639 
Feeding of children . . 470 
Feeling, one of the senses 46 
Feet, description of . . 38 
Fennel, sweet, aromatic . 538 
Fern, male and female, useful 
in coughs, and remedy for 
tapeworm, .... 538 
Fever, in general . . . 162 
bilious, or remittent 171 

hectic, or consumption 269 

inflammatory . . f 200 

intermittent, or ague 164 

malignant, or yellow 372 

miliary .... 265 

milk, in lying-in women 440 

nervous, or typhus 184 

puerperal . . . 453 

scarlet .... 266 

Fibres, description of . . 40 
Fig-tree, a mild caustic . 539 
Finger, dislocation and frac- 
ture of 364 

Flag, blue, active cathartic 539 

sweet, aromatic 539 

Flannel, wearing of, promotes 

health 144 

Flatulence, in infants . . 492 

in adults . 300, 302 

Flaxseed 539 

, infusion of, good 

remedy in cough . . 226 
syrup, how made 539 



INDEX. 



681 



Page 

Flea-bane, promotes urine 540 
Flies, potato, equal to Spanish 574 

how collected 575 

Flower-de-luce, cathartic 540 

Fluor albus, or whites . . 409 
Flour, caudle, how prepared 622 
Flowers, pernicious effects of 74 
Flux, or dysentery ... 281 
Flux-root, remedy in colds 540 
Food, how received into the 
stomach and digested . 54 

rules to be observed in 

taking .... 78, 80, 616 
Foxglove, a most valuable me- 
dicine in inflammatory com- 
plaints 540 

Fractures of the limbs : . 362 
of the small bones 364 

of the ribs . . 368 

French apple, cures epilepsy 542 
Frost-wort, useful in king's evil 542 
Frozen limbs, management of 221 
Fumitory, useful in eruptions 543 



G. 



Galen, how he became con- 
verted 34 

Galling, of infants ... 480 
Gall bladder, use of . . 57 
Gamboge, doses of . . . 630 
Gaming, a horrid practice 133 
melancholy occur- 
rence of 134 

good advice on . 134 

Gangrene, or mortification 360 
Garget, useful in rheumatism 543 
Gargles, how prepared . 660 
Garlic, excites blisters . . 543 
Gentian, stomachic . . 543 
Gillenia, common, emetic 544 

Ginseng, demulcent and sub- 
stitute for tobacco . . 544 

manner of preparing 

for exportation . . . 545 
Glands, their use ... 40 

Gleet, treatment of . . . 324 

Glossary 667 

Glyster, or clyster, simple and 

emollient 662 

common . . . 662 

86- 



Page 

Glyster, stimulating . . 662 

anodyne . . . 662 

turpentine . . . 662 

nourishing . . . 663 

mode of administering 654 

Golden rod, a tonic bitter 545 

Gonorrhoea 320 

Gonorrheal inflammation of 

the testicle cured by purga- 
tives 324 

Goose grass, useful in gravel 

complaints .... 545 

Gout 319 

doctor, anecdote of . 319 

Gratitude, the most exalted 

virtue 153 

Gravel 277 

Greene, General, his death and 

character 229 

Green sickness .... 403 

Grief, injurious to health . 109 

deep, cause of insanity 

and death 110 

its best remedy . . 110 

Gripes, in infants . . . 492 
Grog blossoms .... 332 
Ground holly, useful in gravel 546 
Ground pine, useful in rheu- 
matism, Sec 546 

Ground pink, remedy for worms 546 
Guinea pepper .... 546 

worm .... 344 

Gun-shot wounds . . . 358 
Gum pills 646 

H. 

Hamilton, Honourable Paul, 
his description of button 

snake root 525 

of the pleurisy root 571 

of the squirrel ear 584 

his mode of admin- 



istering the May apple . 558 
Archibald, Lieut., 

his death and character 525 

Harriet, her unhappy fate 101 

Hartshorn, spirits, doses of 630 

Hare lip, management of . 4S'2 
Hart's tongue, remedy in di- 

arrhcea 546 



682 



INDEX. 



Page 

Harvey, his sublime sentiments 37 
Hatred, destructive to mind 

and body 120 

Head, description of . . 44 

injuries of . . . 365 

■ water in the . . . 499 

Headache 249 

Hearing, difficulty of . . 251 
Heart, description and use of 49 
grand organ of circula- 
tion 50 

Heart-burn 299 

Heart's ease, useful in cuta- 
neous affections . . . 546 
Heart snake-root, an emetic 
and diaphoretic . . . 547 

Hectic fever 270 

Hellebore, remedy in cuta- 
neous diseases . . 547, 548 
Hemlock, useful in many ob- 
stinate cases .... 548 
Hemorrhoids or piles . . 279 
Hemorrhoidal ointment . 663 
Henbane, useful in convulsions 549 
Herb bennet, good for ague 549 

trinity, for eruptions 549 

Hernia, or ruptures . . 347 

Hiccough 296 

Hill, Dr., his effrontery . 580 
Hippocrates, his desire to cure 

covetousness .... 126 
Hip joint, rheumatic affection of 256 

Hives or croup .... 500 

Horehound, good for coughs 551 

Hoarseness 218 

Hog-bed, promotes the menses 549 
Holwell, Col., his account of 

the black hole in Calcutta 69 
Homoeopathy, account of 510 
Homceopathic medicine . 512 
medicines, pre- 
paration of .... 513 
Hooded widow herb, antidote 

to canine madness . . 549 
Hope, the source of human 

happiness 105 

— its great influence on 

the state and disorders of the 

body 106 

, ill-grounded . . 107 

Hop beer, how made . . 550 



Page 

Hops, anodyne and antiseptic 550 

Horse-radish, stimulant . 552 
Hosack, Dr., a distinguished 

botanist 518 

Hospital, a cheap plan recom- 
mended to planters . . 34 
— ought to be establish- 
ed in our sea port towns 34 
Houseleek, useful in burns and 

stings of insects . . . 552 
Hunger, painful sensation of, 

explained 55 

Hunter, Dr., slept comfortably 

under snow .... 91 

Husbands, affection of some 99 

cruelty of some 131 

Hydropathy, or water cure 506 

Hydrophobia 344 

Hydrocephalus, or water in the 

head 499 

Hygieine, or the art of preserv- 
ing health 64 

Hypochondriac disease . 290 
Hypochondriacs, ludicrous ca- 
ses of 291, 292 

Hypocrisy 151 

Hyssop, useful in asthma, &c. 552 

Hysteric fits 287 

I. 



Idleness, the bane of virtue 
Iceland moss, decoction of, 

good for cough . . 
Ice-plant, useful in fits 
Imagination, force of . 
Imperforated anus . . 
vagina 



105, 



226 
552 
416 

483 
483 
620 
158 
140 



Imperial drink . . . 
Impiety, consequences of 
Impudence, disgusting 
Incontinence of urine, how 

treated by Dr. Bell . . 277 
Incubus, or nightmare . 297 
Indian hemp good for rheuma- 
tism 553 

physic, safe emetic 553 

tobacco, good for colic 553 

turnip, good for coughs 553 

Indigent, sick, often neglected 608 
Indigestion or dyspepsia . 300 



INDEX. 



683 



Page 

Indigo weed, emetic and ca- 
thartic 554 

Indolence, source of disease 87 
Infants, management of . 466 

., diseases of . . 478 

Infection, how to arrest . 198 
Inflammation of the brain 228 

of the lungs 242 

of the liver . 243 

of the stomach 245 

of the intestines 247 

— of the kidneys 248 

of the bladder 249 

— of the breasts 447 

of the womb 450 

of the eyes . 237 

— of the pleura 242 

of the throat 230 

Inflammable air, how to correct 71 
Inflammatory fever . . . 200 

Influenza 212 

Infusion of roses . . . 650 

of oak bark . . 650 

of galls ... 650 

of Peruvian bark 652 

of Columbo . . 653 

of gentian . . 653 

Ingenhouz, Dr., his remarks on 

the properties of plants 73 

Inhalations .... 218, 273 
Injections for gonorrhoea . 660 
Injuries of the head, &c. . 365 
Inoculation for small-pox, from 

whence derived . . . 263 
Intemperance, vice of . . 127 
a miserable re- 
fuge from misfortune . 128 

. reclaimation from 131 

Intermittent, or ague and fever 164 
Intermittent fever, best method 

of treating 169 

remedies re- 
commended as highly bene- 
ficial 169, 170 

Intestines, use of . . . 53 

Intoxication, symptoms of 339 

how to treat 339 

Inversion of the womb . 445 
Ipecacuanha, American, emetic 554 
—doses of . . 630 



Page 

Iron, carbonate of, useful in tic 

douloureaux .... 257 

Iron filings, how exhibited 653 

Issues 371 

Itch 333 

lotion, how prepared 658 

Ives, Professor, attests the vir- 
tues of blood-root, in certain 

cases 523 

Ivy 554 

J. 



Jalap, doses of ... . 
Jamestown, or jimson weed, 

useful in many complaints 
Jaundice, or yellow gum . 
infantile . . . 



Jealousy, horrid effects of 
Jefferson, President, his death 

and character . . . 
Jerusalem oak, vermifuge 
Joan, queen of Naples, mur- 
ders her husband . . 
Johnson, Dr. formula to pre- 
serve the stomach and regu- 
late the action of the bowels 
in inflammation of the liver 
Jones, Hon. Dr., asserts the ef- 
ficacy of cotton in scalds 
Joy, excessive, often fatal 
Judkins' ointment, good for 

buboes 

Juniper, an excellent diuretic 

K. 

Kidneys, use of . ' . . . 
inflammation of 



630 

554 
336 
486 
103 

283 
554 

104 



244 

346 
109 

239 
554 



57 

248 



Kingston, Sir Wm., his cruel 
mode of taking revenge 121 

King's evil 335 

Knee, dislocation of . . 364 



L. 



Labour 427 

Laborious labour . . . 434 

Lacedemonians, politeness of 140 

Laceration of the parts . 445 



684 



INDEX. 



Page 

Lafiteau, Father, first discover- 
er of ginseng in America 545 
Lambkill, for itch . . . 555 
Lassitude, prognostic in fevers 208 
Lavater's remarks on females 98 
Laudanum, doses of . . 630 

how prepared 656 

Lavender thrift, for sore throat 555 
Laurel, for diarrhoea . . 555 
Laxative medicines . . 635 
Leeches, mode of applying and 
preserving, and checking the 
discharge of blood . . 615 
Legs, description of . . 38 

fractures of . . . 365 

Lemonade, how prepared 619 

Lemon tree, antiseptic . 555 

how to preserve the 

juice 555 

Lettuce, garden, an excellent 

anodyne 555 

wild, a powerful diu- 
retic 556 

Lichen, useful in coughs . 556 
Life-root, remedy for gravel 557 
Ligaments, description and 

use of 38 

Lightning, to recover persons 

apparently killed by . • 340 
Lime water, how prepared 657 

doses of . . 634 

Limekiln, dangerous effects of 72 
Lind, Dr., on the influence of 

the mind over the body 106 

Liver, description and use of 56 

inflammation of . 243 

enlargement of . . 245 

Lobelia, useful in venereal 557 
Lochial discharge . . . 444 

Lock jaw 294 

Longings 178, 417 

Looseness, or cholera infantum 495 
Looseness, in pregnancy . 418 
Love defined .... 96 

influence of . . . 96, 97 

propitious, conducive to 

health 100 

disappointed . . 100, 101 

Lover, false, a detestable cha- 
racter 104 



Page 

Louisa, affecting history of 100, 101 

Low spirits 290 

Lumbago 256 

Lues venera, or confirmed pox 326 
Lungs, description and use of 48 
inflammation of . 241 



Lying-in women, diseases of 442 
M. 

Madder, useful in visceral ob- 
structions 557 

Mcintosh's, Dr., treatment of 

syphilis 329 

Mac Pheeters, Dr., celebrates 
black mustard, as emetic, in 
malignant fever . . . 388 
Macbride, Dr., finds blood root 

useful in hydrothorax . 523 
Magnesia, doses of . . 630 
Magnolia, good in rheumatism 557 
Maiden hair, useful in coughs 558 
Malignant fever .... 372 
letter from Louisiana 



to the author respecting 372, 373 

— Cartwright's essays 

on, noticed .... 374 

symptoms of . 374 

three distinct stages 

of 374 

— treatment of 375, 388 
animal and vegeta- 



ble putrefaction, agency of 
in producing . . . 385, 386 

bayous do. . 392, 393 

— — prevention of . 393 
cholera. See cho- 



lera, epidemic or malignant 305 
Malignant or putrid sore throat 232 
Mallow, useful in dysentery 

and gravel .... 558 
Mandrake, an excellent purga- 
tive 558 

Manna, doses of . . . 630 
Marsh, trefoil, tonic bitter 559 

Marsh-mallow, good emollient 559 
Marsh rosemary, for sore throat 559 
Master-wort, tonic . 559 

Materia Medica . . . 517 
May apple, purgative . . 560 



INDEX. 



685 



Page 

Mayrant, Col., celebrates Sam- 
son snake root as a remedy 
for dyspepsia .... 581 
May weed, stomachic . 560 
Mease, Dr., deserving of high 

praise 518 

Measures and weights, table of 627 

Measles 264 

Meconium, observation on 469 
Medicines, table and doses of 628 
————— approved manner 

of administering . - . 390 
Medicine, the importance of 
possessing some knowledge 

of 28 

■ ■ necessary caution in 

the use of 30 

— — - - subject to abuse 28 
the necessity of tak- 
ing agreeably to directions 613 
Membranes, description of 40, 43 
Menstruation .... 398 
-^— — — cessation of 400 
— — — - — painful . . 401 

suppression of 403 

profuse . . 406 

Mercurial pills, how prepared 655 
————— solution . . . 655 

ointment . . 663 

Mezereon, useful in venereal 

and cutaneous affections 560 

Midriff, description and use of 52 

Miliary fever .... 265 

' eruptions . . . 453 

Milk fever 444 

blotch 487 

Milk, or silk weed, useful in 

gravel, &c 560 

Milkwort, useful in coughs and 

colds ..... 560 
Mind or soul, obscivations on 47 
Mindererus spirits, how pre- 
pared 639 

Mint, allays vomiting . . 561 
Mineral tonics .... 651 
Miscarriage ..... 424 
Misletoe, useful in fits . 561 
Mitchell, Professor, deserving 

high commendation 518 

Modesty, its great influence 137 
Mole, or false conception 460 



Page 

Moore, Dr., cites a case rela- 
tive to imagination . . 416 
Moorwort, remedy for toe itch 561 
Mortification, or gangrene 360 
Moschetoes, bite of . . 342 
Motherwort, useful in nervous 

affections 561 

Mountain tea, promotes men- 
strual discharge ... 561 
Mouthroot, tonic bitter . 561 
Mugwort, good stomachic 562 
Mulberry tree, an excellent 

purgative 562 

wine, how made 562 

Mulled wine, to prepare . 625 
Mullein, good for piles . 562 
Mumps, treatment of . . 236 
Muscles, description of . 39 

Mustard, excellant stimulant 563 

whey, how made 625 

Music, powerful effects of 118 
Mutton broth, how made 623 



N. 



Narcotics, observations on 647 
Navel cord, or string, manner 
of tying .... 431, 467 

presentation of 438 

Neopolitan, manifests unboun- 
ded love for his wife . 99 
Nervous fever .... 184 

headache . . . 250 

Nerves, description and use of 39 
Nettle-rash, treatment of . 332 
Nettle, stinging, an excellent 

stimulant 563 

Night-shade, usefel in rheuma- 
tism and in tic douloureaux 564 

deadly, used in 

palsy, epilepsy, &c. - 563 
Night-mare, or incubus . 297 
Nipples, sore . , . . 448 

mode of pre- 
venting 449 

Nitre, doses of ... . 630 
Nitric acid, diluted . . . 655 
lac ammoniac, how pre- 
pared 643 

Nitrous lozenges, how pre- 
pared 645 



686 



INDEX. 



Page 

Nose, bleeding from . . 267 
Nostrils, description and use 

of 46 

Nostrums, dangerous conse- 
quences of .... 28, 225 
Nurses' Guide .... 608 
Nurse, duty of ... . 609 

, caution to 611, 613, 617 

Nursing infants .... 474 
Nutrition, proper for children 469 



O. 



Oak, astringent, tonic, and 

antiseptic . . . 565, 566 
Oak, poison, good for palsy 566 
Obstructed menses . . . 403 
Ointment for piles . . . 280 

for scald bead . 335 

simple ... 663 

saturnine . . 663 

basilicon . . 663 

mercurial . . 663 

— hemorrhoidal . 663 

tar .... 663 

itch .... 664 

thorn-apple . . 586 

Omentum or caul, description of 56 
Onions, remedy in liver com- 
plaint and croup . . 566 
Opiates, caution in the use of 242 
Opium, doses of . . . 630 
Opodeldoc, how prepared 658 

Opthalmia or sore eyes . 239 

strumus or sore eyes 239 

Orange-tree, antiscorbutic 567 

wine, how made . 567 

Original imperfections . 481 
Ovaria, ovaries, situation and 

use 58 

Oxygen, or pure air . . 67 



P. 



Ill 



Pagan religion, account of 
Painful affection of the face, 

or tic douloureaux . . 256 
Pain of the ear ... . 251 
stomach . 293 



Page 

Pain of the head . . . 249 
Pains, after, of lying-in women 443 

false in pregnancy 421 

of the back, thighs, and 

abdomen, in pregnancy 420, 421 
Painful menstruation . . 401 
Palate, elongation of . . 235 
Palmer, Mr., anecdote of 321 

Palpitation of the heart 203, 296 

in pregnancy 418 

Palsy, treatment of . . 289 
Pancreas, or sweet bread, its 

use 57 

Panado, how made . . 622 
Papaw, purgative . . . 567 
Papoose root, useful in ob- 
structed menses and dropsy 567 
Paraphymosis .... 324 
Parents, caution to . . . 476 
Paragoric elixir, doses of . 630 

how prepared . 656 

Parrot, killed, by eating the 

berries of pride of China 576 
Parsley, leaved, yellow root, a 
good stomachic . . . 567 

■ wild, useful in gravel 568 

Passions, the active forces of 

the soul ..... 95 

Patent medicines, why dan- 
gerous .... 28, 29, 225 
Patriotism, definition of . 147 

Themistocles . 148 

of French soldier 148 

of English sailor 149 

— of Americans 149 

Peach-tree, a mild cathartic 568 
Pectoral drink, how made 620 



mixture or emulsion. 



634 



the 



doses of .... 
Penny-royal, promotes 

menses 569 

Peppermint, allays vomiting 569 
Pepper, red, stimulant . 569 
Peripneumony, or inflamma- 
tion of the lungs . . 242 
Peritoneal inflammation . 451 
Perspiration produced by ex- 
ternal applications . 177, 201 
Petechial fever .... 184 
Philemon, died laughing . 109 



INDEX. 



687 



Page 

Phrensy, or inflammation of 

the brain 228 

Philopcemon, the great, taken 
for a servant .... 143 

Phymosis 323 

Physic, Dr., his excellent ad- 
vice in hemorrhage of the 
extremities .... 356 

Piles 279 

Pills, mercurial .... 655 

for inflammation of the 

liver , 244 

purgative .... 637 

— — of sugar of lead, and ipe- 
cacuanha 650 

camphor and assafoetida 649 

Pink root, excellent vermifuge 570 
Pins, swallowing of . . 345 
Piss-wort, promotes urine and 

menses 570 

Placenta, or after birth, mode 

of extracting . . . 433,439 
Plantain, antidote against the 

bite of venomous insects 570 
Plaster, blistering, how made 664 

, warm and stimulating 658 

Pleurisy, treatment of . . 240 

■ — root, remedy in cold 

and pleurisy .... 571 
Plurality of children . . 437 
Plutarch's observations on 

bashfulness .... 140 
Poison, swallowed . . . 342 

— oak, useful in paralytics 571 

— antidote for . . 572 

Poke weed, useful in rheuma- 
tism 572 

Polygonum, promotes urine 573 
Polypody, mild laxative . 573 
Polypus, in the womb . . 458 
Pomegranate, mild astringent 573 
Poplar tree, good tonic, &c. 573 
Poppy, white, anodyne . 574 

syrup of . . . 574 

mode of cultivating 

and collecting the juice 574 

Potato fly, mode of collecting 574 
Potato, sweet, nutritious 574 

wild, purgative . 575 

pudding, how made 6'24 

Potter, Professor, his remarks 



Page 



used 



on stimulantSj as 

fevers 193 

Pox, treatment of . \ . 326 
Prejudices, ill consequences 
of ..... . 29, 614 

Pregnancy, signs of . 412, 413 

— force of imagina- 

416 

417 

27 

435 



tion in 



— diseases of 



Preliminary observations . 

Preternatural labour 

Prickly ash, remedy in rheu- 
matism, &c. . . . 575 

— — — pear, remedy for corns 576 

Pride of China, remedy for 
worms, scald head, &c. 



Progress of labour . 
Prognosis of fever . 
Prometheus, his history of in- 
temperance .... 
Prostrate glands, situation and 

use of 

Ptolemeus, cries for joy 
Puccoon, good for jaundice 
Puerperal fever . . . 
Pulse, its action described 
Purgative infusion, how pre- 
pared 

powder 



- electuary, doses 



how prepared 
pills 



and 
634, 



Purging, or diarrhasa 

of infants 

Putrid fevers . . 
— sore throat 



576 
428 
204 

128 

58 
108 
577 
453 
206 

637 

637 

637 
637 
304 
469 
184 
232 



Q. 

Quacks, cause of their increase 
Quaker girl's attraction . 
Queen of the meadows, diuretic 
Quince tree, mucilaginous 
Quinine, preparation of . 
not to be administer- 



28 
146 
577 
577 
652 



ed at random in intermit- 
tent fever 

solution of . 

sulphate, pills of 

Quinsy, or inflammatory sore 
throat 



169 

654 
654 

230 



688 



INDEX, 



R 



Page 

Radish, antiscorbutic . . 577 
Raleigh, Sir Walter, forbear- 
ance of . . . , . 118 
Ramsay, Dr., his melancholy 

death 358 

Rash, nettle . ... 332 

Raspberry dissolves tartar on 

the teeth 577 

Rattlesnake root, remedy for 
croup and cold . . . 577 

violet ... 579 

bite of . . 343 

Rayschachius, sudden death 

of, from grief .... 110 
Red cedar, substitute for savin 579 

Red gum 486 

Regimen, importance of in 

sickness ... 33, 609, 616 
Religion, promotes health 150, 157 

extremes in, to be 

avoided ..... 152 

purifies and en- 
hances our enjoyments 154 

Remittent, or bilious fever 171 

or bilious fever, 

prevention of . . . . 182 

Respiration, prognostic of dis- 
ease 207 

Resuscitation of persons appa- 
rently dead .... 340 

Revenge, horrid instance of 121 

advice to the Ro- 
mans respecting . . . 121 

Bolea's way of taking 122 

Rheumatism 254 

Rheumatic tincture, how pre- 
pared 656 

Rhubarb, wild, purgative 579 

Ribs, description and use of 37 

Rice milk, how made . . 621 

caudle, do. ... 622 

pudding, do. . . . 624 

Rickets 504 

Ring worm 333 

Rose or erysipelas ... 488 

Rose, damask, mild laxative 579 

willow, remedy in gleet, 

&c 580 



Page 

Routs, dangerous tendency of 68 
Rue, produces blisters, &c. 580 
Ruptures .... 347, 483 
Rush, Professor, esteems wine 
a preventive of disease 596 

his death and character 199 

Rust of steel, doses of 631 



S. 



Sage, was supposed by the an- 
cients to prolong life . 58G 
Sago jelly, how prepared 620 

Sailor, American, patriotism of 150 
Sailors, deserve kind treatment 35 

— too inattentive to health 182 

Saliva, use of ... . 46 

Sal ammoniac, volatile, dose of 631 

crude, solution 

of 658 

Salt of tartar, doses of . 631,642 
Saline julep, or mixture, dose of 634 
Saline, how prepared . . 638 
Samson snake-root, remedy in 

dyspepsia 581 

Sanicle, American, for cancers 581 
Sarsaparilla, good for rheuma- 
tism ..-..•. 581 
Sassafras, purifies the blood 587 
Saturnine, or lead water, how 

prepared ..... 658 
Scald head . • . . . 334 
Scalds and burns . . . 346 

Scarlet fever 266 

Scirrhus or cancer . . . 352 

Sciatic 256 

Scrofula, or king's evil . 335 
Scull cap, for hydrophobia 582 

Scurvy 330 

Scurvy-grass, antiscorbutic 582 

Sea-sickness 338 

Secretory vessels, their use 40, 55 
Seminal weakness . . . 325 
Senna, American . . . 582 
Senses, inlets of pleasure 44 

Setons and issues . . . 371 
Sexual weakness . . . 409 
Shippen, Dr. Wm., father of 

the Pennsylvania Univeisity 230 
Ship fever . . • . . 184 
Shaw, Professor, his death 568 



INDEX. 



689 



Page 

Shiverings, in childbed . 443 
Sight one of the senses . 46 
Sickness and vomiting of in- 
fants 490 

Sinapisms, how prepared . 664 
Skin, the functions of ex- 
plained 40, 41 

diseases of . . . 331 

Skoke for ulcers and wounds 582 
Skunk cabbage, useful in asth- 
ma 582 

Slaves, brutally murdered 116 
proper manner of treat- 
ing 34 

Slave trade abominable . 71 

Sleep, most reviving cordial 91 

how to be regulated with 

infants 472 

effects of too much or 

too little ...... 93 

— — after dinner, whether 

advisable 93 

talking or walking in 93 

signs of, in fever . 209 

Sleeplessness . . . 196, 420 

Slow fever 184 

Small-pox . . . . • 261 

how managed in 

Queen Mary's time . . 262 

history of . . 263 

Smell, one of the senses . 46 
Smith, Professor, discovers the 
utility of blood-root in poly- 
pus 523 

Snakes or serpents, bite of 343 
Snuffles of infants . . . 485 
Soapwort, valuable in jaundice, 

&c 583 

Socrates, maxim of . . 78 

oolander, Dr., his advice to 

travellers in cold weather 89 
Solution of arsenic, doses of 628 
how pre- 
pared 657 

Solution of crude sal ammoniac 658 

of kali .... 659 

Somnambulism and somnilo- 

quism 93 

Sore eyes 237, 480 

nipples 44S 

throat .... 230, 232 

87 



Page 

Soul, immortal .... 47 

Sorrel, antiscorbutic . . 583 
Southern wood, stomachic 583 
South sea tea, diuretic . 583 
Spaniards, their cruelty to the 

Indians 117 

Spanish woman, her extraordi- 
nary hope 107 

Speech, blessing of . . 47 

Spence, Dr., attests the efficacy 

of foxglove in consumption 540 
Spikenard, good in gout . 583 
Spirit of mindererus, how pre- 
pared 639 

— — of turpentine, mode of 
administering . . . 649 

of lavender, doses of 631 

Spitting of blood ... 268 
Spleen, description of . 57 

Spleenwort useful in coughs, 

&c 584 

Spotted fever .... 184 
Sprains and bruises . . 361 
Spruce laurel, useful in venereal 584 
Squirrel ear, antidote for the 

bites of serpents . . . 584 
Star grass, an intense bitter 584 
Stevenson, Dr., his remarks on 
bowel complaints . . 281 

his mode of treat- 

291 



467 
637 



ing a hypochondriac 
Still-born infants, mode of re- 
covering 

Stimulant purgative pills . 
Stimulants, how to exhibit 647, 648 
Stings of insects . . . 343 
Stink weed, for cutaneous 

eruptions, &c. . . . 584 
Stomach, description and use of 52 
- aperture in St. Mar- 



tin's, described by Dr. Beau- 
mont 

Stools, prognostics in diseases 
St. Anthony's fire . . . 
St. Martin the young Canadian, 
experiments on digestion 
made in his case by Dr. Beau- 
mont 

Strangury .... 277, 
Strawberry, cooling and laxa- 
tive 



83 
206 
267 



83 
419 

584 



690 



INDEX. 



Page 

Stroke of the sun . . . 228 

Structure of human machine 36 
Strumous opthalmia or sore 

eyes : 239 

Sumach, common, anti-vene- 
real 585 

Sulphur, doses of . . . 631 

Sudorific drops, or bolus . 640 

Sun dew removes freckles 585 

Superstition source of delusion 151 

Suppression of urine . 276, 418 

Sutures, mode of applying 357 

St. Vitus's dance . . . 504 

Swallowwort, good for cold 585 

Swallowing of pins . . 345 

Sweating, immoderate . 166 

Swelled leg .... . 446 

Swelling of feet in pregnancy 419 

of head in infants 479 

of breasts in do. 479 

of scrotum in do. 479 

Swine pox 265 

Swooning or fainting . . 442 

Sympathy 52, 56 

System, the, certain states of 

in remittent fever in which 

the use of bark is forbidden 181 

T. 

Table of medicines for family 

use ...... . 628 

Table of weights and measures 627 
Taliaferro, Hon. John, his re- 
medy for whitlow . . 350 
Tansy, vermifuge . . . 585 
Tape worm . . ... . . 463 

Tapioca jelly, how made . 620 
Tartar emetic, doses of . 632 
Tartar on the teeth, how to re- 
move and prevent . . 253 
Tar water, how prepared 657 
Taste, one of the senses 46 
Tea, properties of ... 82 
Teeth, management of . 253 

Teething 494 

Temperance promotes health 

78, 129, 132 
Tendons, description and use 

of 39 

Tetany or lock jaw . . 294 



Page 

Tetter or ring-worm . . 333 

Thatcher, Dr., deserves praise 518 
Theodosius, emperor, his anger 

subdued by music . . 119 

Thighs, description of h. 38 

dislocation of . 364 

fracture of . . . 364 

Thomas, Dr., attests the effi- 



cacy of Cayenne pepper in 

putrid sore throat . . 
of charcoal to stop 

bleeding of the nose 
Thorax or breast, description 

of 

Thorn apple, remedy in mania, 

epilepsy, &c 

of a child- 



case 



234 

268 

48 

586 



587 



swallowing the seed 
Thoroughwort, useful in fevers 588 
Throat root, for sore throat 589 

sore 232 

Thyme, good aromatic . 589 
Thrush, or sore mouth . 489 
Tic douloureaux . . . 256 

remedies for 258 

symptoms of 256 
treatment of 257 
632 
632 
656 
656 
656 
656 
656 
656 
656 
334 
620 



632, 



Tincture of steel, doses of 

of myrrh . . 

of rhubarb 

of bark . . 

of Columbo . 

of foxglove 

of cantharides 

, rheumatic 

of laudanum 

Tinea, or scald head . 
Toast water, how made 
Tobacco, for colic, dropsy, &c. 589 

used for tic doulou- 

257 

used for toothache 257 



reaux 



Toe itch, good for toe or ground 

itch 593 

Tongue, description and use of 47 

appearance of, an im- 

209 
482 
651 
66* 
252 



portant prognostic 
Tongue-tied, how remedied 
Tonics, class of ... 
Tonic powders, and pills . 
Toothache ..... 



INDEX. 



691 



Page 

Toothache-tree, for rheuma- 

matism and venereal . 593 

Toot rash - . . . . 487 

Topical blood-letting . . 369 

Touchwood, excellent styptic 593 

Tourniquet, how to apply, 325, 356 
Travellers in winter, caution to 90 

Treacle posset, how made 621 
Trefoil water, emetic, and ca- 

s thartic 593 

Troup, Hon. G. M., his deaf- 
ness cured .... 252 
Tulip bearing poplar, tonic 593 
Turmeric, diaphoretic . 593 
Turlington's balsam, how pre- 
pared 656 

Turner's cerate .... 663 
Twins, or plurality of children 437 
Typhus fever, treatment of 184 
Typhoid pneumonia, or epi- 
demic ...... 226 



U. 



Ulceration of the navel . 479 
Ulcers common . . . 353 

ill-conditioned . 550 

Ureter, description and use of 57 
Urethra, description of . 58 

Urine, prognostic in fever 210 

difficulty in voiding 276, 418 

incontinence of . 276 

suppression of . . 278 

Unicorn root, useful in colic 593 
Uterus, description of . 57 



Vaccine disease . . . 258 
Vaccination discovered by Dr. 
Jenner in 1798, as a preven- 
tive against small-pox 263 
Vagina, or neck of the womb 58 

protrusion of . . 455 

Valerian, wild, useful in nerv- 
ous disorders .... 593 

Vanity, effects of . . . 134 

cure of ... . 137 

Vapours, or low spirits . 290 
Vegetable substances, how col- 
lected and preserved . 606 



Page 

Vegetation of plants, corrects 

impure air 73 

Veins, their use .... 40 

Venereal disease . . . 321 

prevention of 330 

Venesection, or bleeding, how 

performed 369 

Vine, grape, cultivation of 594 
Violet rattlesnake root, reme- 
dy for scrofulous tumours 602 
, sweet, mild laxative 603 



Virgins' bower, useful in cuta- 
neous affections . . . 603 
Virginia, or black snake-root, 

promotes perspiration . 603 
Volatile sal ammoniac, mode 
of administering . . 648 

liniment, how prep. 658 

Vitriol, white, doses of . 632 
Vitriolic solution, doses of 634, 651 

how prep. 650 

Vital air 67 

Voltaire, his conversion . 159 
Vomiting and purging, or 

cholera morbus . . . 304 
Vomiting in infants . . 490 

W. 



Wakefulness, or inability to 

sleep 

Wake robin, for blistering 
Walnut, white, cathartic . 
Warm bath, virtues of 32, 43, 
— how to be regula- 



ted 



Warm and discutient liniments 
plaster 



Warts and corns . . . 
Washing of infants . . 
Washington, GenL, his death 
and character 

Mrs. L., her mi- 



raculous recovery 
Water cresses, antiscorbutic 
Water trefoil, antiscorbutic 
Water, impure, how to correct 
Water gruel, how made . 
Watery head .... 
Watery rupture .... 
Wayne, General, his death 



174 

604 
604 
202 

202 
658 
658 
349 
471 



179 
b04 
604 
82 
621 
499 
483 
320 



692 



INDEX. 



'' 



Page 

Weakness of the stomach 300 

Weaning • 473 

Weems, Dr., his prescription 303 

his death . 303 

Wells, dry, danger of « . 72 

Whitlow 350 

White swelling .... 337 
Whites, or sexual weakness 409 

White gum 486 

White caudle, how made 622 

White bryony, purgative . 604 
White wood, tonic . . . 604 
Whooping-cough . . . 503 
Willow, astringent and tonic 604 
Wistar, Dr., attests the effica- 
cy of nitric acid in liver 
complaints .... 245 

his death and cha- 
racter ...... 230 

Wine, excellent preventive 
and remedy of diseases 594 

use of, is economy 595 

abuse of, injurious 595 

receipts for making 597 

adulteration of, how to 

detect 600 

cautions in administer- 
ing in fevers .... 192 

whey, how prepared 625 

Winterberry, tonic . . . 605 
Wintergreen, for itch . . 605 
Womb, or uterus, description of 57 



Page 

455 
445 
459 
458 
450 
439 



Womb, falling down of 

inversion of . 

cancer of . . 

polypus in the 

inflammation of 

hemorrhage from 

Wood, betony, good in rheu- 
matism 605 

Woodhouse, Prof., his death 567 

Worms 462, 498 

Worm-seed, vermifuge . 605 
Worm-wood, stomachic . 605 

Wounds 356 

Wrists, dislocation of. . 364 



Y. 

Yarrow, astringent, remedy for 

bruises and cancers 
Yeast, utility of, in nervous 

fevers 

corrects fetid ulcers 

receipt for making 



Yellow fever 



Yellow gum 



prevention of 



605 

188 
550 
551 
372 
393 
486 



Zimmerman, Dr., his judicious 
mode of treating religious 
melancholy .... 152 



